How to Reduce Your Risk and Reclaim Your Health

There’s a silent health crisis affecting millions of people—and you may be one of them. Chances are, you don’t even know it.

What’s this stealth threat? Poor metabolic health. And in this episode, I’m joined by nurse practitioner and intermittent fasting expert Cynthia Thurlow to get clear on what’s causing this epidemic and what we can do to turn it around.

You’ll learn why women are more likely to struggle, the two most pressing changes to make, when fasting might not be right for you, and how you can be proactive about reducing your risk of long-term disease.

Even if you’re metabolically well, someone in your life likely isn’t—and this episode could be the beginning of a journey to better health.


00:02:53 – What does metabolic health mean?
00:04:58 – What is insulin resistance?
00:06:03 – The surprising place insulin resistance begins
00:07:54 – Are we looking at the wrong things?
00:09:34 – Early indicators you can test
00:13:25 – If your doctor won’t order the labs, do this
00:14:45 – What’s behind this trend?
00:17:37 – This is what happened when Cynthia was on HRT
00:21:54 – Why do women struggle more and what can we do to change it?
00:23:36 – The most important thing to start with
00:26:33 – The biggest challenge with fasting
00:28:52 – How many times a day are people ingesting calories?
00:31:25 – Choosing the appropriate dietary tool for you
00:32:55 – More crucial tools for your metabolic health
00:36:34 – Is there a way to measure stress?
00:39:22 – Remember this if you’re feeling overwhelmed

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Read my book, The Sugar Impact Diet

Learn more about Cynthia Thurlow

Read Intermittent Fasting Transformation

Listen to Everyday Wellness

Study: Metabolic Syndrome and Related Disorders: Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016

Monitor your metabolic health with YourLabWork

Own Your Labs


Read The Ultimate Weight Solution by Dr. Phil McGraw

Study: Cell Metabolism: A Smartphone App Reveals Erratic Diurnal Eating Patterns in Humans that Can Be Modulated for Health Benefits 

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Click Here To Read Transcript

ATHE_Transcript_Ep 611_Cynthia Thurlow
JJ Virgin: [00:00:00] I'm JJ Virgin, PhD dropout, sorry mom, turned four time New York Times best selling author. Yes, I'm a certified nutrition specialist, fitness hall of famer, and I speak at health conferences and trainings around the globe, but I'm driven by my insatiable curiosity and love of science to keep asking questions, digging for answers, and sharing the information I uncover with as many people as I can, and that's why I created the Well beyond 40 podcast to synthesize and simplify the science of health into actionable strategies to help you thrive.
In each episode, we'll talk about what's working in the world of wellness from personalized nutrition and healing your metabolism to healthy aging and prescriptive fitness. Join me on the journey to better health so you can love how you look and feel right now and have the energy to play full out.
I have one of my favorite guests back [00:01:00] again. It's Cynthia Thurlow. She is best known for her book, Intermittent Fasting Transformation, and she's known as a fasting expert because of her. Multiple TEDx Talks with over 14 million views. However, we are going to shift gears now and talk about metabolic health.
Kind of step up from intermittent fasting because that can totally help restore metabolic health. We'll dig into a little bit about who should fast and who shouldn't fast and all of that as well. But we're going to really dig into metabolic health. What it is. What's causing the big challenges we have with it.
Most importantly, what we can do to start to shift it around. Now, if you missed the other interviews I've done with Cynthia, we will link to them in the show notes and we'll also link to all of her information. I'm going to put that at because that is the name of her awesome podcast, Everyday Wellness.
You've probably seen Cynthia, gosh, where? ABC, Fox, KTLA, CW, [00:02:00] Medium, Entrepreneur, even the Make Me Kelly show. She's been all over the place, focusing on her mission to educate women on the benefits of both intermittent fasting, but bigger than that, on having optimal metabolic health so that they can live their most optimal lives.
So I will be right back with Cynthia Thurlow. Stay with me.
All right, Cynthia Thurlow, welcome back.
Cynthia Thurlow: Thank you, JJ. I've been so looking forward to reconnecting with you and recording podcasts together.
JJ Virgin: Well, you've been very busy since you launched the intermittent fasting transformation. And what I really want to dig into today is like to go beyond that, because that was like the start.
But now you're really getting into metabolic health, which I mean, I can't imagine anything more important with the current status of our metabolic health. So let's dive into that. Like where are we now and what does this even mean?
Cynthia Thurlow: Yeah. So prior to the [00:03:00] pandemic. There was a UNC School of Chapel Hill study that came out and it talked about at that time 88.
2 percent of Americans were not metabolically healthy.
JJ Virgin: But what does that even mean, that not metabolically healthy?
Cynthia Thurlow: Yeah, so it's really speaking to people that are insulin sensitive, individuals that are able to have a healthy blood sugar response that are not prescribed medications to treat blood pressure, are not prescribed medications to address diabetes, have a healthy waist circumference.
Have a healthy lipid panel. It's that basic that we are now in a position as a country where you are an outlier if you are not insulin resistant. And so I look at this as a crisis that not enough individuals are talking about. And so when we think about, that was 2018 when that study came out, we go through the pandemic, we come out of the pandemic, we are less healthy.
Now it's 92 to 93 percent of Americans are not metabolically healthy. And what that really speaks [00:04:00] to is we have a crisis of not just adults with high blood pressure, diabetes, metabolic syndrome, cardiovascular disease, neurocognitive disorders, polycystic ovarian syndrome, which is the number one cause of infertility.
We're looking at a generation of children that are also not as metabolically healthy and very likely will not be as healthy as their parents. And so I look at this as a clinician, I look at this as a crisis to speak of. And so when I'm speaking to women, especially in perimenopause
and I used to tell patients. And I always say, know better, do better. But I think people understand this piece of insulin resistance is at the basis of every chronic health issue that we're seeing. It is inflammation, oxidative stress, and insulin resistance that is really creating a lot of these chronic health problems.
JJ Virgin: And let's break it down for [00:05:00] everybody listening as to what is insulin resistance. Yeah.
Cynthia Thurlow: So we have many hormones in our bodies, but it's helping us understand that when we eat food. We have a corresponding reaction. Our body will appropriately try to maintain homeostasis, which means our body wants to keep our blood glucose within a very narrow parameter.
And so when we eat protein versus carbohydrate versus fat, our bodies have a corresponding reaction to each. So if you eat a steak with some broccoli and a baked potato, you're going to have a different blood sugar response than if you sit down and eat a big gulp and a package of cookies. Not surprisingly, having processed carbohydrates are going to have a more impactful effect on our blood glucose.
So we have our glucose, which when we eat meals, that can be impacted, whether it's higher or lower. And we have insulin that is a hormone that is designed to help [00:06:00] move glucose from our bloodstream into cells. And over time, if we're dealing with chronically high blood glucose, which is what most Americans are dealing with in response to chronic stress, poor quality sleep.
Crappy processed diets, lack of physical activity, and understanding that insulin resistance actually starts in our muscles. That's why the value of physical activity is so important, helping people understand over time, if our blood glucose or blood sugar is too high over time, those cells become less sensitive, like a locking key mechanism, telling our body to take that glucose and shuttle it into the cells.
So over time, our cells become less sensitive to insulin's effects. We can develop things like non alcoholic fatty liver disease, which is the number one liver problem here in the United States right now. It's not cirrhosis like it used to be 15, 20, 30 years ago. We can develop elevated triglycerides, which again is a response.
Our body is looking for a way. To [00:07:00] correspondingly address chronically high glucose levels. And so at a very basic level, we talk about insulin resistance. What we are really speaking to is this loss of insulin sensitivity. Imagine your cell is a front door and you're banging on the front door. No one can hear the message because it has been desensitized over time.
So It starts off as insulin resistance and then progresses to diabetes. And that's what we're trying to, you know, help people understand what are the things we can do proactively that can lessen our likelihood of going onto developing disease. We want to people to understand that you can reverse these things.
This is not. Once you get a diagnosis, this means this is forever. I love sharing with people the message of hope that understand there's a lot that we can do at our disposal to help reverse the effects of insulin resistance.
JJ Virgin: I know we're going to get into that, but before we do, I, there's a couple things I want to unpack because.
When I hear all of this and really look at insulin resistance at [00:08:00] really the core of all of these challenges, it feels like we're looking at the wrong thing. The focus now, we're starting to look a lot more at blood sugar, but blood sugar to me feels like a lagging indicator. And I'm just wondering why we're not focusing more on things like fasting insulin, triglycerides.
It's like I look at the metabolic health numbers and they say, okay, you're You're metabolically healthy if your triglycerides are 150 or less, but I would argue you've got an indicator right there of a problem. So, What are you looking at to really identify if someone is insulin resistant and, you know, what's happening first?
Because isn't it by the time we start to see some blood sugar abnormalities, a whole lot of stuff's gone down the pike, right?
Cynthia Thurlow: Absolutely. And I think that there's nothing more frustrating because my whole background was in critical care cardiology. And towards the end of 2016, when I left clinical cardiology, I kept saying to my colleagues, I think we're [00:09:00] missing something.
If it's taking 10 years for a patient to get a diagnosis, that's the average. 10 years to get a proper diabetes diagnosis. What is going on behind the scenes that we are not addressing? So to your point, fasting insulin is way more sensitive for looking at insulin resistance way before a fasting glucose, an oral glucose tolerance test, a hemoglobin A1c, which I don't even draw anymore.
Looking at that fasting insulin is one of the most important markers. And I like to see that between two to five milligrams per deciliter. So when a woman comes to me as an example, that I'm weight loss resistant, my fasting glucose is fine, my A1C is fine. And then we draw a fasting insulin and it's 15.
I'm like, okay, this is the canary in the coal mine. To your point, the triglyceride piece. I like it below 75 because that is oftentimes a reflection of how much carbohydrate, usually the processed carbohydrates. What's your HDL? You know, we [00:10:00] talk about it being this heart healthy cholesterol. There's so much more to lipids than that.
That's kind of this old school thought process. But we know that if your HDL is less than 55, that in and of itself is a core prognostic indicator of metabolic health. And so helping people understand, we like to look at That fasting glucose, and this is not your grandmother's fasting glucose. When I was in a nurse practitioner school 25 years ago, we used to tell patients, Oh, 120 was fine.
130 was fine. Oh yeah. You would talk about 140. You know, it was much higher than it is now. And I say, when you put your feet on the floor in the morning, I want to see your fasting glucose between 70, 75, and 85. That's where I wanted to see. We know if you have a fasting glucose between 90 and 99, you are at 30 percent greater risk of developing diabetes.
That is from Dr. Robert Westate, who is one of these preeminent endocrinologists and metabolic health experts. And so I really start to dial back the layers to see [00:11:00] what else could be going. What are your inflammatory markers doing? What's your high sensitivity CRP? What's your homocysteine? What's your leptin?
Now, you can have a normal insulin and have an elevated leptin, and that can be from a variety of different things. But if someone says to me, I eat a good dinner and then I'm still hungry. I start to think what else could be going on and leptin resistance can be problematic because that's speaking to communication between the brain and the gut and helping with satiety.
There are other, you know, adiponectin, there's other markers you can look at. I don't per se use that as a front line, but I think that fasting insulin can be very, very insightful. And here's the thing, I've had physicians refuse to draw these for patients. Because they don't know how to interpret it. And I lovingly say, then you need to figure that out because when you understand how valuable it is, it's covered by insurance.
And there's a company I'm not affiliated with, but I usually will refer people. I'm like, if your position or healthcare provider won't draw up for you, you [00:12:00] can go to own your labs. I have no affiliation with them. And for like 12, you can get a fasting insulin drawn. And I think it's very much a proactive situation where you can yourself, even if your healthcare practitioner is not willing to draw up for you, you can monitor some of your labs.
On your own. And it's all about empowerment. We want to be able to look and see is your fasting insulin normal six months ago, and then maybe you were impacted by the virus. Maybe you, your thyroid was underactive. Maybe you, you had a diagnosis and you weren't able to be as physically active and you suspect that there might be latent insulin resistance going on.
You can look at those numbers and you can use them for comparative reasons. I was able to discern that my thyroid wasn't fully optimized because my fasting insulin, although still within that normal range, was starting to creep. And I was like, I could tell that there was some degree of beginning latent insulin resistance, especially as we were adjusting my hormone replacement therapy.
I think for [00:13:00] everyone listening, it takes about 20 years for conventional research to actually come into clinical practice. And so I always say if your healthcare practitioner is still using what they learned 20 years ago and they, they're not willing to unlearn or they're not willing to reconsider other options, I always say we are designed to be lifelong learners as clinician.
If they're not willing to relearn, then you need a new clinician, as I heard you say,
JJ Virgin: well, if the doctor won't order it for you, then you can go over here. I go, if the doctor won't order it for you, then get a new one. Correct. And get a new healthcare practitioner who's. Up on this stuff, fascinated by it and wants to be on the cutting edge of it.
Cynthia Thurlow: Absolutely. 'cause this is not new information either. No. And I think the other thing that I find so frustrating is I am comfortable enough as an individual to say, 20 years of I didn't know better, but now I do. And now because I know better, I wanna make sure you get the best information. And for me, metabolic health is [00:14:00] so tied up into what's going on with us and perimenopause and menopause.
And if we have not become our own best advocate by that point, you lost. As we're losing estrogen, I always say we lose those people pleasing skills, that all of a sudden we're less concerned with what people think of us. And we're like, Hey, this is not okay. And you know, there are many, many providers out there that can provide the level of care that you're
JJ Virgin: looking for.
So you just listed The challenge, insulin resistance and how it's expanded and dramatically increased during the pandemic, no surprise, the surprise of it even being 88 percent and how this isn't considered the biggest epidemic of our time is bizarro and it's just being ignored, that's even weirder, but what's behind it?
Because we can't fix something if we don't know what's creating the issue.
Cynthia Thurlow: Yeah, I mean, I think that there's multiple things that are at play here. I think that it's the food that we consume. [00:15:00] We know that 60 to 70 percent of Americans consume hyper processed, hyper palatable food. So the food that's easy and very addicting to eat, I think we eat too frequently, but we'll just put that in there.
I think we don't manage our stress, and certainly the last three years have shown that. We're not physically active. And when I said insulin starts in your muscles, That is based on research. This is not just contrived. We are designed to move. We are not designed to be sedentary. I think a great deal of it is also impacted by the endocrine mimicking chemicals we are exposed to in our environments.
You know, we live in a very toxic environment. And I read recently that some of these endocrine mimicking chemicals are a thousand times more potent than the actual hormone. And I say that again, a thousand times more potent than the actual hormone. Our hormones don't stand a chance. And if you think about the water supply, like as one example, most water does not filter out [00:16:00] oral contraceptives, hormones that we urinate into the system, antibiotics.
We are just bathed in these hormones, these synthetic hormones all the time. And it's interesting. I was talking to a colleague and I said, well, is there any filter that filters out all these synthetic hormones? And they said, no, unfortunately. So we have this chronic overexposure. And then I also think about how many people don't value high quality sleep.
I don't think I valued sleep enough until I hit perimenopause. And then when it went south, I was like, okay, this is something I clearly need to prioritize. But how many people don't appreciate or value high quality sleep? So I think that there's many things that contribute. I would tag on to that as understanding, you know, 22 years ago when the Women's Health Initiative study came out and the onslaught of that, I was a new nurse practitioner and I recall all my patients were removed from hormone replacement therapy and these women would [00:17:00] cry.
About how they suddenly went from being able to think clearly and have a libido and just be able to function and sleep. And all of a sudden they weren't. And so we had a whole generation of clinicians that were fearful to prescribe hormones. Women were afraid to take them. And that's starting to turn, thankfully.
But understanding that as women are navigating perimenopause into menopause, we're losing insulin sensitivity just by virtue of losing estradiol. It's important for women to understand, like, whether you choose to take hormone replacement therapy or not, you need to understand the net impact on your health.
And this is something That I can speak from a personal circumstance, I was on HRT, I was on too much. We stopped it. I went off for six months, although I was still taking progesterone. My clinician came to me when he drew my labs and he said, I would never know that your labs came from you had they not been drawn in my office because the amount of inflammation and [00:18:00] oxidative stress, just being off of estrogen for six months.
It's unbelievable. And so I feel like I have to share these stories to say, I've always looked healthy from the outside, but not being on estrogen for me, was profoundly detrimental to my metabolic health. I'm back on it now, along with testosterone and progesterone. But I share this so that people understand, like, you can look healthy on the outside.
And for many of us not being on HRT in and of itself will really adversely impact our metabolic health. And so I think that conversation has to be had. I think that we need to not be fearful to have that conversation. And whatever decision you choose to make, you have to make it with the understanding of what that impacts.
Whether you're on HRT or not, how it impacts bone and brain and muscle health,
JJ Virgin: et cetera. Yeah. Bone, brain, heart. So I used to work out of a medical spa where they would have me do the nutrition and fitness programs for the patients. And they would come in and have their labs drawn and I would look at their [00:19:00] labs and I could tell by their labs and their age if they were on hormone replacement therapy or not.
And it was insane, the difference. The cardiovascular risk factors were just the jump right off the bat.
Cynthia Thurlow: Want me to tell you what my ApoB was and I can explain like what that is. So you want your ApoB, which is a marker of inflammation and oxidative stress, you want it less than 80. When I was off
Cynthia Thurlow: of HRT was 139.
You know, I went through this full cardiac workup. I had a coronary artery scan. I had a special carotid ultrasound. I mean, I have done all these things that have happened. So it's no surprise when you were working in that environment, you could clearly see who was on it and who was not.
JJ Virgin: And this was 15 years ago and it was like, holy smokes, what a difference.
I'm just so fortunate that I was surrounded by gynecologists when all of my hormones started to go sideways, and I didn't have to go through this. I was [00:20:00] listening to your list, so I don't think you know this, I used to teach this course for healthcare practitioners called Overcoming Weight Loss Resistance.
It all happened because Dr. Phil had a book, and in the book he had a chapter called Weight Loss Resistance. It really was about insulin resistance, but I started to go through what are all the things that could get in the way of you losing weight or cause you to gain weight. And it was toxins, you know, obviously we had to fix the diet and exercise.
It was stress. It was sleep. It was sex hormones. It was thyroid. It was gut health. It was insulin and leptin resist. It was all of those things, right? And the thing is. They're not independent of each other. If you have cortisol issues, you'll probably have thyroid issues. If you've got estrogen issues, you'll probably have insulin issues.
Then you'll have inflammation, like they all would become this tangled web. But at the very basis of this, and we talked about this in your podcast, was this concept that I learned from Dr. Diana Schwartzbein of you must. Get healthy to lose weight. You don't lose weight to get healthy. Now I would put in front of it, because that was 20 plus years ago and we didn't have this term [00:21:00] yet, is that you don't lose weight to get metabolically healthy, you must get metabolically healthy to lose weight.
So there are all of these issues. And I guess we could do a diagram to go, which are your issues and address your top priorities and go down the line, but how do you take someone coming in? And the first obvious thing is. We've got to measure the right things. Again, if you've got a doctor who's not looking at things like fasting insulin or an ApoB, the numbers we now know that are so predictive.
If you were going to pick one thing to look for cardiovascular risk, you'd be smarter to look at an ApoB. So these numbers that are so predictive of what's happening. And because a lot of these things, you don't become diabetic overnight. You become diabetic over time and there's signs all along the way.
Just like success leaves clues, you know, there are signs all along the way that this is happening to you. You do not wake up one morning diabetic. So what are the things then that we can do to start turning this around? And [00:22:00] why do you think, especially for women, are, are women just not doing the right things here?
Like what's happening with women where they're really struggling with this?
Cynthia Thurlow: Well, I think there are several things. I think in many ways, until women are 40 ish, that. We are prioritizing everyone else in our life. Our children, our significant others, our employers, our friends, and then things start to go south. So when I think about the most important first thing to address is sleep, because if I can get a woman to sleep through the night, I can get them to lose weight.
And I explain that to them when I talk about the changes that are happening physiologically in our bodies and early perimenopause, late 30s, early 40s, you're going into early ovarian failure, our ovaries are as old as we are, you know, people hate hearing that, but it's the truth. Early ovarian failure, how does that show up?
Cause our ovaries are responsible for the hormone [00:23:00] progesterone. So that can show up as some insomnia. It can be some anxiety, some depression. It can show up as estrogen dominance. So women start having much heavier menstrual cycles. And our adrenal glands are designed to be this emergency backup system, but the quarterback has to step in.
You know, our adrenal glands get called upon to help support us hormonally as this transition is occurring. And so one of the first things I do, and especially when they come to me and they're like, well, I was prescribed a sleep aid and I was given Paxil or Prozac or Zoloft or whatever antidepressant or anti anxiety agent.
And I always say, well, the main thing that we need to start with is. Let's get your sleep dialed in. So sleep hygiene, you know, making sure you're not sitting on your iPad or your laptop computer until midnight and getting that second wind. Help people understand that we do have. This whole sleep ritual, just like when we are raising little people and we have a ritual for them so their bodies know it's time to go to bed, it's helping people understand, you know, maybe wearing blue blockers [00:24:00] in the evening, getting off electronics, maybe you need a bath, maybe you need to soak in magnesium, maybe you need to read a book.
In addition to, you know, maybe as a perimenopausal woman, maybe you need progesterone the week prior to your menstrual cycle. I mean, something so simple can be so effective. I mean, I've had women that have said that progesterone for them in early perimenopause or even middle perimenopause has been life changing.
So I can get you to sleep through the nights. I can get you to manage your stress. I can get you to make better food choices. I can get you to show up better in your personal life. So sleep is number one. And there's lots of hacks around sleep, but I would say you need the basics to be able to do that.
Because we know based on research, if I can get you to sleep through the night, your blood sugar is going to be better balanced. You're going to wake up in the morning. You're going to make better choices when you do eat meals. And actually that first meal of the day is the most important meal for setting up your blood sugar response for the rest of the day.
And why is this relevant? [00:25:00] We know that if you have a protein laden breakfast, which I know is something that you are a fan of, you know, first meal of the day, whether it's 11 o'clock in the morning, nine o'clock in the morning, a protein laden breakfast is going to keep your blood sugar stable and it's going to reduce the likelihood that you're going to have cravings.
So we call it hyperphagia. Versus if you sit down and have a bowl of cereal, you have a Pop Tart, you have a croissant that's five times the size of the croissant that you would ever get in France, you are going to have much better blood sugar control. And we know that it's more aligned in the circadian biology.
We are designed to actually eat earlier in the day, not later. We are more influence sensitive earlier in the day than we are later on. So it all goes back to figuring out ways that we can support our bodies to make sure we optimize our hormonal regulation, but doing it in a way that is sustainable.
Because you and I both know there's always like the next get quick fix. You know, this one thing, this potion pill or powder is going to fix everything. And I tell everyone, we really do have to [00:26:00] make lifestyle changes that are sustainable so that we can go on and be able to sustain things. So, you know, that first meal of the day, having some protein, understanding protein is satiating, understanding you want at least 30 grams of protein to trigger this muscle protein synthesis.
I know we talked about that this on my podcast, but helping women understand how critically important that protein piece is. And then I'm a huge fan of intermittent fasting, if that's appropriate for you, but only intermittent fasting if you can actually get your protein in. So I'm not a fan of OMAD.
JJ Virgin: But here's what I think is the biggest challenge with the fasting umbrella.
There is fasting, intermittent fasting, time restricted feeding, OMAD, every other, it's like, okay, so when you talk about it. Because you did write the book, right? So we have to address it. When you talk about it, what specifically are you talking about? When is it appropriate? When is it not appropriate?
[00:27:00] Let's
Cynthia Thurlow: break it down. Yeah. So when I talk about intermittent fasting, it's a period in time in which you Abstain from eating food or caloric beverages in a period in time in which you eat. The most important thing that you can take away from this conversation about intermittent fasting is not starvation and it is not restriction.
It is not designed to be restrictive in the sense that you are, you should be nourishing your body. I think that there is this common misnomer on social media that What we're suggesting is people starving themselves. That is not what we're doing. We're just saying we're going to eat two meals a day or three meals a day and in a, in a seating window.
And helping people understand that the individuals that are appropriate for intermittent fasting are individuals that can manage their blood sugar. They're individuals who are sleeping well. And I go back to that sleep piece. If I can get you to sleep through the night, I can get you to make good food choices.
I can get you to get to a point where intermittent fasting is a viable option. It's not an option if you're pregnant or breastfeeding. It's not an option [00:28:00] if you have a distorted relationship with food, anorexia, bulimia, or binge eating. Have I met women? That fall within those parameters and have gone through enough support and services with their psychologists, eating disorder specialists, and are able to intermittent fast, sure, but it's the minority or people that are chronically sick because.
When I find that someone's on 15, 20, 30 medications, they need to loop in their internist because they need an adjustment in their blood pressure medicine, they need an adjustment in their cholesterol medication, they need an adjustment in their diabetes medicine. But most other individuals, my teenagers included, can eat for 12 hours of digestive rest, meaning that there's a 12 hour window in which you do not eat.
Most people can do that, they just are terrified to do that. The average that I read recently was One of Sachin Panda's research was looking at meal frequency. And the amount of time people drank caloric beverages and food, it was 10 to 12 times a day. It's wild. [00:29:00] And I thought to myself, that's 10 to 12 times a day that your body is trying to process a bowl of food and or a sugar sweetened beverage.
And we talked about insulin resistance and how that can impact it quite significantly. So I always, from the context of helping people understand what intermittent fasting is, not starvation. It is not designed to keep you protein deficient because we know as women are getting older, we need more protein, not less.
So when I see someone that says to me, I am OMAD all the way, team OMAD seven days a week. Oh boy. How
JJ Virgin: do you get enough protein, OMAD? How, if we need to get at least a hundred grams. How is this working?
Cynthia Thurlow: You can't. I always say I come from a place of education and I just want women to be able to make good choices, healthy choices, and if you're getting 35 grams of protein in three meals a day, great.
If you can get by with 50 in two, fantastic. But you definitely want to be ensuring you're getting enough protein. That is the most important macronutrient at this stage [00:30:00] of life in particular, because we need more, not less. Right. So that's, that's my soapbox about OMAD. And this is also why when people ask me, am I a fan of prolonged fasting?
You know, 24 hours, 48 hours, 72 hours. Not if you're already lean because it's at the expense of your muscle. And so I've gotten more and more outspoken about this. I am a lean 52 year old and I do not do long fasts anymore. I don't because I want to maintain my muscle. And so I think when you find that reframe, it's not coming from a place of judgment.
It's coming from a place of empowerment. And I want every listener here to understand like, yes, you can intermittent fast. If you have 30, 40, 50 pounds to lose, you can get by with a little bit of longer fasting, but making sure on those other days you're eating sufficient amount of protein. So protein is definitely what you want to be focused on if you are choosing to intermittent fast, for sure.
JJ Virgin: you know, it comes to this bigger umbrella of [00:31:00] diets are tools. They're tools. So to me, an intermittent fast of eating for 12 hours, fasting for 12 hours is actually just the way we should eat. To me, that's like, Stop eating, shut the kitchen down after dinner and don't go in there until after you've been up for an hour or two, ideally two, shut the door.
What you decide to do after that really is. What's the effect you're trying to achieve. And then you choose the appropriate dietary tool, not the tool that your manicurist told you was working perfectly. You know, this used to drive me crazy. I go, eating does not make you a nutritionist.
Cynthia Thurlow: Very true. So
JJ Virgin: careful where you're reading this advice or taking this advice.
And then I also find that with all of these diet books. Everyone tends to write the book. I can totally say this now with the next book I'm writing. They write the book for them. They write the book that's working for them. So that doesn't mean that's the book for everybody. It's your tools. Pull the stuff that you need for what you're [00:32:00] attempting to achieve there.
All right. Sleep again. I honestly, I don't know how to help someone with insulin sensitivity, like, unless they are sleeping well.
Cynthia Thurlow: That's the care I incentivize people. I'm like, listen, this is the way I can get you to a point where your body will be in a position where it can get healthy to lose weight.
If I can get you to sleep. And this is also how I'm able to say to women, stop staying up until one o'clock in the morning to do stuff. Go to bed. Like my whole family laughs at me. I'm the first one in bed. Obviously, I'm not irresponsible. I wait until my kids are home, but I am the first person in bed because I know that I need to sleep.
I need a solid eight hours a night of sleep to function best. There's no shame in that. Like the years of getting by with four and five hours of sleep completely. We're not helpful for me in terms of, you know, navigating perimenopause. So sleep is the way for sure.
JJ Virgin: Okay. Beyond sleep, what are some of the other things here?
Like maybe some supplements or gut health, like what [00:33:00] else is
Cynthia Thurlow: critical? I mean, I think that, you know, when we're talking to women about navigating perimenopause and, and to menopause, I mean, stress management is without question. We know that chronic stress. Even high cortisol, low cortisol, I mean, it will show up as adiposity around your abdomen.
So we talk about there's 40 times more cortisol receptors in our abdomen. So when someone is dealing with acute on top of chronic stress, they'll sometimes say, I have the menopause, you know, I have all this adipose tissue that I don't know what to do with. But understanding that Managing your stress is not five minutes of meditation once a week.
It is a proactive way of managing your stress day to day. It could be like, I have two dogs and my husband love to be hugged. So I can like get a little oxytocin boost and understanding this hormone oxytocin gives you a little bit of a reduction in cortisol on the short term. It doesn't last forever.
The connection to nature, meditation, which I know you're a huge fan of. For me, it's, you know, getting outside and just putting my feet in the earth. It's starting to get colder where I am right now, but I do [00:34:00] genuinely love that. For me, it's reading a book, like reading a book for pleasure. I love doing that.
The funny thing is that you enjoy doing, because that is going to help buffer that cortisol response. But I would also think about things like myo inositol can be very helpful for not only sleep support, but also stress management, also insulin sensitivity. This is something that's naturally occurring in the body.
We don't make enough of it. It gets depleted very easily, but I'll be able to understand, you know, there's a little hack. Whether it's myo inositol, creatine, which I know we're both fans of, helps with sleep architecture. Also, there's some metabolic effects that can be very helpful. When people are dealing with chronic stress and they feel like wired and fired, I start to think about adaptogenic herbs, ashwagandha.
I think about L theanine or gamba. All of these things are very nourishing to the adrenal glands, but also very helpful. L theanine is a compound that's found in things like green tea. So it's also naturally occurring, but. I don't know how many people even have decaffeinated tea right before bed. So those are the things I think about [00:35:00] along with, I gotta be honest with you, we know that trauma has a large impact on not only autoimmune conditions, but also has a huge net impact on weight loss resistance.
There is that connection. I interviewed Dr. Gabor Amate, and I was stunned looking at the statistics in his book, that helping people understand, like, unprocessed trauma. There's, you can go online and look at these scaled, like, adverse childhood events. If you have a high score, you're at greater risk for developing an autoimmune condition.
You are at greater risk for weight loss resistance. You are at greater risk for, you know, this chronically over activated sympathetic nervous system. And I know JJ's talked a lot about the sympathetic nervous system, which is the… I'm being chased by a rabid animal system, but most of us are living in these chronically over activated sympathetic nervous system.
So those are the things I think about along with gut health does play a role. We know chronic cortisol can disrupt the gut microbiome. We know there's something called the estrobola, which is this kind of awkward, strange word. How our body is able to actually [00:36:00] process up and package estrogen and get rid of it effectively.
That's why a bowel movement every day, the bare minimum, it's not normal to poop once or twice a week. I still mean, when I. I think that's completely normal, but cleaning up your personal care products, cleaning up your water. You know, we have a filtration system in our house. We had our water tested.
There's lots of different ways to kind of look at how you can limit your exposure to toxins, but all these things definitely play a role, not only in metabolic health, but also then insulin resistance and optimizing our health as we're navigating middle age and beyond.
JJ Virgin: I want to just go back to stress.
Just for one minute, do you have a way that you look at this? Because. It would be so awesome if there was a way we could test our sympathetic nervous system and really see what the heck is going on,
Cynthia Thurlow: right? Yeah, I mean, I think that a rough estimation of looking at heart rate variability, so I wear an Oura ring and I can tell when my HRV is lower than it should [00:37:00] be.
Obviously, there's age adjusted heart rate variability. I don't expect as a 52 year old that my heart rate variability is going to be what a 20 year old is, but there is yours. It's good if I'm in the 50s. I'm really good if I'm at 60, but if I'm in the 20s, it usually means I didn't get enough sleep or I'm traveling.
I really tank when I travel. That's a given. Like, especially if I'm jet lagged, my HRV will end up in the toilet. But based on like what I read in my understanding is it's really looking at this balance of the autonomic nervous system, parasympathetic to sympathetic. We want balance that most of us tend to be revved up and we don't have enough restorative time.
It could be taking a nap on the couch. You could be reading that good book. It could be sitting outside in nature. It could be taking your dogs for a walk, loving on your animals or your significant other, your spouse, your kids, you know, just getting that oxytocin released, but that is. What I think is a good, quick, safe way of observing heart rate variability is a good way to get some insights into the autonomic [00:38:00] nervous
JJ Virgin: system.
It's interesting. I was just checking and I remember hearing Peter Atiyah talking about something and it was like the number 13. 7. I think that there wasn't like, as long as you were not below that. And I'm just one of those people that has a sucky HRV. Like I'm happy if it's 20. So I just started looking, cause I was
Cynthia Thurlow: like, 50, you're my hero.
But it didn't start there. I mean, once I started tracking and then there were some biohacking female I had in my podcast. So I'm very fond of. And she posted what her HRV was one day. And I was like, I know you're in your thirties, but dang, I mean, it was like well over a hundred. I was like, how do you know?
Yeah. So, so I think some of it's genetics. I think there's absolutely a role in there, but if I'm in the fifties, I'm doing good, but jet lag, or if I'm at elevation, I'm super sensitive to elevation. Yeah, I was in the toilet. I was in Denver and the whole time I was there is like my HRV is like 15. Terrible.
And then it went back to baseline when I got home. So I think it's looking at acute stress, [00:39:00] chronic stress, balancing that autonomic nervous system. But I certainly think that Having, whether it's a loop band or an aura, I think those tracking devices can be helpful, provided that you don't allow it to ruin your day.
Like if I look at my maturity and it's terrible, I kind of go, okay, note to self, this is not the day to do HRT. Maybe this is the day to do something else.
JJ Virgin: This is really a great reminder. And I think you've just list a lot of things and someone might hear the song go, holy smokes. And what I'm going to just recommend, because you said, okay, if sleep's not there, fix that one first, is that this is peeling an onion.
So like the HRV thing, it was a reminder. I'm like, oh, okay. That's what I'm going to peel next. I'll just start because what you measure and monitor, you can prove. So maybe it's. That you're monitoring your body composition. Maybe you're monitoring your sleep. Maybe it's now HRV, but pick one. And then once you've really gotten that into place, then you can pick the next one.
Otherwise you can listen to all this and go, holy [00:40:00] smokes. I don't know, I'm out, you know, I don't know what to do. And I think you've made a really great case for the stress and sleep piece of this, because those two factors, especially for women. are so huge, holy smokes. And if you're not fixed, like just those two alone, you can be eating correctly, exercising, and you will still be holding onto belly fat, having trouble putting on muscle, being in a bad mood.
So I'm glad that you really hit those ones. Now, I want to make sure that we tell everyone where to find you and your amazing podcast. And then if you have something special to give everyone today,
Cynthia Thurlow: of course. So obviously my podcast is Everyday Wellness. One of my favorite things that I do in my business, I am active on YouTube.
I have a newly relaunched YouTube channel. You can find me on Instagram. You can find me on Twitter. Be forewarned. I can sometimes be a little bit snarky. There's a free Facebook group called Intermittent Fasting Lifestyle [00:41:00] backslash my name. It is a drama free environment, it is a very nice group of men and women that are in there.
But easiest place to go is to my website, www.cynthiathurlow.Com. And yes, I have a little weight loss guide, a quickie that we are gifting to your community.
JJ Virgin: Nice. We'll put all that, like, so all of these things we'll put in the show notes. I'll also put it at
So it'll be easy. The guide will be there. And then of course, all of your information podcast is phenomenal. I'm excited that you're building your YouTube channel.
Cynthia Thurlow: It's humbling. You know, I kind of feel like, you know, we're trying to stay on top of the trends and I'm, you know, doing all the things and you just hope that people are watching and they're interested, invested, because ultimately I'm all about science based strategy and how they can allow us to navigate perimenopause and menopause in a place.
Inspiration and empowerment and not in fear, which I think unfortunately is a byproduct of kind of the [00:42:00] traditional realm. Many women feel that way and I don't want them to feel like, I'm like, learn from my mistakes and the things that I've learned along the way so that you can navigate those years with joy.
With grace and ease.
JJ Virgin: Yes. Yes. With grace. Well, thank you for the work that you do. And thank you again for another amazing podcast. You are always an incredible resource and wealth of information.
Cynthia Thurlow: Thank you. Such a pleasure to be with you.
JJ Virgin: Be sure to join me next time for more tools, tips, and techniques you can incorporate into everyday life to ensure you look and feel great.
And more importantly, that you're built to last and check me out on Instagram, Facebook, YouTube. And my website, And make sure to follow my podcast so you don't miss a single episode at See you next time.
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