The Melanie Avalon Biohacking Podcast Episode #98 - Dr. Will Cole

TRANSCRIPT

Melanie Avalon: Hi friends, welcome back to the show. I am so incredibly excited about the conversation that I am about to have. It is with a repeat guest, that's when you know that you have someone good on the show, and this guest has actually written three books, and I have read all of them. So, I read his first book, Ketotarian, which we haven't done an episode on that, but I think we can probably touch a little bit on it in today's show, which is very, very exciting. Then, he wrote The Inflammation Spectrum, which I did do an episode on that. That was such a wonderful, enlightening conversation, all about obviously, inflammation, but particularly things like autoimmune conditions, and I just refer listeners to that episode all the time. So, if you haven't listened to it, definitely check it out. But now, we come to today's episode, which is the book, Intuitive Fasting: The Flexible Four-Week Intermittent Fasting Plan to Recharge Your Metabolism and Renew Your Health.

And friends, I was obviously very much intrigued and allured by the title of the book, because I am immersed deep in the fasting world, I'm also the host of the Intermittent Fasting podcast, and I'm always really, really curious when a new book or work comes out on fasting, what the approach will be, what information will be in there, what new things might I learn, and I learned so much, and I'm just really, really excited to dive deep into it today. So, yes, I am here with Dr. Will Cole, the fabulous author of all of those books. So, Dr. Cole, thank you so much for being here.

Dr. Will Cole: Thank you so much. It's really nice. I need you to be my hype man, every day, and I just feel so good about myself. Thank you. [laughs]

Melanie Avalon: Surely. I can do that. Sign me up. [laughs] But yes, I really, really mean all of that. Like I said, fasting is my life, especially having the other show, I'm constantly researching it and learning about it and getting questions about it. So, I'm always really, really curious when something especially, a whole book comes out on it, like, what will be the approach here, and I'm not to say that I know everything, but what new things will learn from this book, and I was really excited to read it, because there was so much of that. I mean, that's a good place to start. For listeners, who are not familiar with you, would you like to briefly touch a little bit on your personal story, and I'm dying to know what led you to write a book on fasting, and not just fasting, but intuitive fasting?

Dr. Will Cole: Yeah. So, my day job, my main focus 11 hours a day, I'm running a functional medicine telehealth center. I started one of the first functional medicine telehealth centers in the world over a decade ago. So, my entire career has been via webcam consultation, and we ship labs to people around the world, and provide them a functional medicine perspective on their health issues. So, that's 8 AM-7 PM throughout the week. That's what I'm focusing on. The books that you mentioned, Ketotarian, The Inflammation Spectrum, and now Intuitive Fasting are just ripple effects of my obsession with my patients’ cases and trying to figure out the root components of their health issues and just immersing myself in the research and in functional medicine and these people's journey that I take extremely seriously. So, it's easy for me to write about these things when you're talking about them all day long with people.

So, intuitive fasting-- Let me back up a little bit. Intermittent fasting are things that are different aspects of different ways to use fasting, has been part of my clinical expertise and a tool within the functional medicine toolbox for my whole career. Even prior to me being in functional medicine, I started fasting myself as a teenager. I was a weird kid, and I would buy all these random fasting books. My first book that I read on this was when I was probably 17 years old, maybe 16, even younger. A guy called Jordan Rubin, who's still doing amazing things in the health space, he wrote a book called Patient Heal Thyself, which has been since republished and everything that-- I think the original one was self-published, it was very much a very early book about the fact that how he used many different things, fasting being one of them, to help deal and manage and reverse his ulcerative colitis and Crohn's autoimmune inflammatory bowel issues.

So, I was experimenting with that early on, and my dad was a bodybuilder, and if you know anything about the bodybuilding community in the world, the industry, fasting and ketosis is a major part of that as well. So, since the 1980s, as a little kid, and then in the 1990s, as a teenager, fasting has been part of my life on a personal level too. So, then the ripple effect of that and me being formally trained in functional medicine and clinical nutrition, it just went on to a professional level, not just a personal level. Over the past decade when I'm dealing with people with different inflammatory GI issues or chronic fatigue syndrome, or Lyme disease, or coinfection or mycotoxin, mold issues or autoimmune problems, or in other brain health issues, intermittent fasting is an amazing tool within that toolbox, and not just intermittent fasting, but different fasting protocols can be a great consideration that I'm clinically monitoring people over and with and coaching them and guiding them through these variables that are at play, and getting their labs looking really great, and fasting is a part of that tool.

So, intuitive fasting is just how I've seen intermittent fasting work really well for people. It's, as its name implies, a mindful, intuitive approach to intermittent fasting. When I wrote the book, I started writing the book over 2019, at the beginning of 2019, and then over 2020, and then came out just not too long ago and 2021. When I wrote it, I thought, “You know what? This is there's not been a book like this about intermittent fasting, a mindful-- Just bringing together the world of mindfulness and an inward introspective approach to checking in with your body, and how can you use intermittent fasting in a more mindful way. It's not been done.” I thought this is going to be the most uncontroversial, but poignant and important book on the topic coming from my perspective. This is what I thought I could bring to the conversation, I guess, is what I was trying to say.

It was controversial, and it came out with a few people. A few loud groups of people, mainly the eating disorder community, the body positivity community, the Intuitive Eating community, really took offense to a book they've never read, and if they just would have read the book, they would have known that I wasn't advocating for eating disorders. This is not an eating disorder disguised as a wellness practice. This was a very mindful, measured, practical, healthy relationship with intermittent fasting, and that has been my clinical experience for the past decade.

Intermittent fasting is nothing new, like I’ve mentioned clinically, but I also wrote about intermittent fasting in The Inflammation Spectrum, and in Ketotarian, because it's been part of my books as well. I just wanted to have a bigger, broader, deeper discussion on how I've seen this work for people long-term, and in many ways, it's the past two books coming together in these different aspects with that I've seen patients do really well with, because so much of the fasting books that are out there, they're great and solid science. The world didn't need another fasting book in my opinion, because the science has been explained, and there's brilliant books about that. But a lot of the fasting community of which you're a part of as well, a lot of the doctors or the health professionals or the books that are coming out there are more coming from that biohacker space, and I feel like there's a certain sect of the biohacking community or people that don't even identify as biohackers themselves, but they want to get into this biohacking stuff. But they're not that alpha sort of personality, where they want a more measured approach to this and a more mindful approach. So, that's why I wrote Intuitive Fasting. It's for biohackers, that want a healthier relationship with these things, and more isn't always better. But it’s for all the other people that don't even know that they're biohackers, that I wanted to bring them into the community and say, “Look, you don't have to be Ben Greenfield,” and I love Ben Greenfield, “But you don't have to be that level of immersion and wellness to get involved on these amazing tools that I've seen impact people's lives for the positive.”

Melanie Avalon: I'm so excited to talk more about this, because when the book came out, I saw the controversy surrounding all of it from the different communities, and I understand why that happened, because it's such a sensitive and complex topic that requires a lot of nuance and takes into so many factors. There's not just the diet, there's diet, there's behavior, there's your psychology, there's all of this that goes into it, and I just want to say, first of all, I'm really sorry. It can be really frustrating when people don't actually read what you wrote, and then comment on it. [giggles] It can be a little bit frustrating. But in any case, I'd love to talk a little bit more about all of that, because something I think about a lot, like a lot, on the eating side. Maybe we can talk about the eating before going more into the fasting.

This whole concept of Intuitive Eating, I'm really haunted by this concept, because on the one hand, yes, I feel like we should be able to eat intuitively. Our bodies are set up to find nutrition. We should be able to eat when we're hungry, stop when we're not. There's this idea if we can just get past the emotions of it, we should all be able to be intuitive. But on the flip side, this is my question for you. I don't know if it's always actually possible to be “intuitive” in the environment that we're in. So, processed foods, can you be intuitive with processed foods or if you're in a state of inflammation? Can you still be intuitive? How do you interpret the signals of your body? How do you know what's a craving, and what's an actual need? I think about this so much. So, what are your thoughts on all of that?

Dr. Will Cole: That's really the genesis of the book of what I wanted to have a conversation about, is how can we have, or can we have a mindful, intuitive approach to intermittent fasting and to a mindful approach to eating? Because I see the conversations on social media and within the community about Intuitive Eating, which look, Intuitive Eating, there was a book in the 1990s that was written about this topic. I wanted to have a functional medicine conversation about mindful eating and mindful fasting. So, it's a multitiered conversation about metabolic flexibility, because when somebody is metabolically inflexible, meaning they are, as you say, struggling with chronic inflammation, blood sugar’s all over the place, they're bound by insatiable cravings and hangriness, and fatigue, and blood sugar roller coasters.

So, at that point, it's very true, and this is how I opened up the book is that, is it hangriness or is it intuition? Is it in blood sugar imbalances, or is it intuition? Is it other hormonal imbalances or intuition? Is that insatiable cravings or intuition? Because all of these things are proverbial noises on a physiological level, that will drown out that resolute still small voice of your intuition. So, it's really nice to say on social media, I'm an intuitive eater, and that's just how people identify and with the toxic tribalism that's going on social media specifically, that's their little echo chamber of this is who we are, and we're anti-diet culture. We're going to be this militant cult around our thing, because they have just been so burned by diet culture, that then they're seething in their own rightness.

Look, diet culture and what diet culture has done to a lot of people in the form of shaming people is what I'm trying to say is, shaming people into wellness and obsessing, and being this negative shaming your way into wellness is the antithesis of the message that I speak, the antithesis of sustainable wellness. You can't heal a body you hate is something that I say ad infitum. I say it so many times, because as a functional medicine practitioner, I've seen people try to do this. So, I agree that diet culture is messed up and shaming your way into wellness is not going to happen. But the result then is this rebound equally opposite other extreme, where they suspend all science, they suspend all logic, that you can somehow intuitively eat junk food, and somehow that's going to bring about you feeling great in your body. It's just not possible. Over 60% of the United States has a massive blood sugar problem. This is most people. This isn’t some rare sect of people. So, if Intuitive Eating works for you, and that book resonated with you, that's great, But you're not the majority of the United States. The majority of the United States has a massive blood sugar problem, and there's somewhere on that inflammation spectrum more specifically, the insulin resistant inflammation spectrum, it's that one spoke on that spectrum that I talked about in The Inflammation Spectrum.

So, at that point, the majority of the human race, specifically in the West, today are struggling with hangriness and insatiable cravings, their cravings that hangriness is going to drive them towards invariably most of the time will drive them towards things that perpetuate their problems, and they're going to feel horrible in their own body, and they're actually going to be decreasing their quality of life. So, if you really love somebody, if you really love yourself, you have to ask the question, is that really your intuition? So, we can make it sound nice. We can put a nice filter on it for social media on Instagram. We can make it a hashtag. We can make it a tribe. We can say all these things, but I'm talking to these people offline, meaning off social media, I'm talking to them online via webcam privately, and they're told by their different specialists or Intuitive Eating, eating disorder coach and they're being told to eat all these foods that make them feel horrible. The reality is it's not going to bring about health. If it works for you, keep on doing it. But many people are not served by those broad-sweeping, overgeneralized statements where they're romanticizing junk food, and calling it self-love. Feeding chronic disease isn't self-love. It's actually metabolic problems. So, that's part of the conversation that I wanted to have in the book.

Melanie Avalon: I am just so excited to talk to you about this. Yeah, so, the other day, I was listening to one of my favorite podcasts and I love the host, I love the show, but it was with an Intuitive Eating person, and they were talking about how you should work to eat intuitively and be able to have one Oreo, or some root beer. I listen to so many podcasts, and literally, not that I'm yelling at the podcast, but I was just like, “I don't know if this is the right message here,” because I do think some people can, depending on their personality type, or their current state of inflammation, or blood sugar, or whatever. Some people can eat in moderation, foods that I don't think are benefiting the body, processed foods, things like that. I am not one of them. More power to them, but I think so many people, like you said, it doesn't encourage that, and they feel like failures in a way if they can't eat just one, because they feel like they should be able to eat intuitively, when maybe it's just not a possibility to eat intuitively with these things.

Another layer from that, so, if there was a person who does not have metabolic issues, does not have blood sugar regulation, inflammation, do you think there's still two types of people, some people who can eat whole foods intuitively, and some people who just can't, like, I know for me, I just love food, and that's why fasting works so well for me. So, even when I'm eating whole foods, I can eat a lot, and once I'm eating, I like to keep eating, and that's why I said again, fasting works so well. Do you think there are still two types of people when it comes to that, or do you think everybody can reach a state of pure food intuition with eating?

Dr. Will Cole: Genetics play a part of that for sure, and people's own early relationship, like, the mental, emotional, spiritual component to someone's relationship with food, and their body definitely plays a role on that. So, that side of things, and the genetic side of things, there's definitely some those facets that are at play when it comes to somebody's ability to be more mindful when it comes to food and satiety signaling. A large part of the conversation that I'm having in Intuitive Fasting is the fact that metabolic inflexibility or rigidity, that stuff that drowns out that intuition. The more metabolically flexible somebody comes, they were gains for themselves. The more flexibility they have the more fat burning and sugar burning flexibility that they have in their body, that lowers inflammation levels, that balances blood sugar levels, that optimizes satiety signaling, and then brains communication with the endocrine system, and the gut brain axis is improved. All of that stuff from a functional medicine perspective are the physiological infrastructure stuff, that you have to physically build for your body to have a more sound, aware, mindful, introspective relationship with food in your body.

So, even you doing fasting, you're mindful of what works for your body and what doesn't. That's really the conversation that I want people to have, but they’re not even conscious enough to even know what works for their body and what doesn't, because they're so bound by the inflammation and the blood sugar imbalances and the hormonal imbalances. So, the way that I built the protocol in Intuitive Fasting is these vacillating, ebbing and flowing, expanding, and contracting eating and fasting windows. So, it's a way to add the analogy that I use in the book is this proverbial yoga class for your metabolism. If somebody goes to yoga, they've never known yoga before, their hamstrings are tight, their core is weak, their bodies just like never done it before. They could go to yoga, and even a beginner's yoga class and they're going to think what the heck? Yoga is completely unnatural. How could the human body ever do this? They could blame yoga and say, “Yoga is not for me. Yoga is not my jam.” But the reality is, it's not Yoga is fault, it's their own inflexibility. Most people are bound by that inflexibility right now on a metabolic level, and they'll do intermittent fasting, and it's going to seem completely unnatural.

On one level, look, it's paradoxical on purpose. Fasting will be anything, but intuitive when someone's metabolically inflexible. But the more flexibility somebody builds for themselves, they're going to be able to calm that noise, hear that intuition, have proper signaling pathways to be able to have a healthier, more balanced relationship when it comes to food and fasting. Fasting will be more intuitive, when you're metabolically inflexible, not because it's restrictive, not because it's disordered eating disguised as a wellness practice, but because you can go longer without eating, because you're more stable, because you are more metabolically flexible. So, that's the other side of the coin of metabolic flexibility. You can use intermittent fasting to gain metabolic flexibility, but as a ripple effect of metabolic flexibility, you will just randomly, intuitively fast, because you have a more sound relationship and an awareness on what works for your body and what doesn’t. So, that's what you notice in your life, like, you feel the best having this balanced relationship with fasting and eating, and you know your body. It's a tool within your toolbox to continue your health journey, and that's what I want for everybody, and what I call in the book, food peace, is having this inner peace with food, because so many people are at war with their body and at war when it comes to food, and food is their enemy, but yet this medication that they use to make them feel better, and they feel oftentimes completely out of control.

So, I don't want people to have an unhealthy obsessive control, which is disordered eating, but have a stillness on food peace of saying, I can eat whatever I want, but I want to eat things that make me feel good, and avoiding foods that don't make me feel good isn't restrictive, it’s self-respect. I like feeling great more than I thought that I miss something that made me feel really lousy. That's what food peace is. Intermittent fasting in the food protocol that I put in the book is really built towards people discovering that for themselves, because that's our birthright. Fasting is encoded in our DNA. The homeostasis is encoded in our DNA. If we allow our body the time to find that for ourselves, we can start to feel great and feeling alive in our body, because most people, they feel really miserable in their skin, and it's physiological stuff that's really fueling that. Chronic inflammation doesn't feel good. Blood sugar imbalance doesn't feel good. You're not going to feel good, and like I said, you can make it sound great on social media, and it’s going to be your highlight reel of this amazing way that you are going to fight diet culture, but I promise you, metabolic disorders don't feel good any way you put it.

Melanie Avalon: Yeah, all of that resonates with me so much. For listeners, Dr. Cole touched on it but if you get the book, there is a very, very detailed specific plan to follow, which is so incredibly helpful for people who want to jump into this, especially for people who are the type that like the plans and something to follow. So, I just want to thank you so much for that resource. A question about the nuance of Intuitive Fasting. You talk about the evolution of fasting throughout history, throughout culture, and also biologically why we are so just set up and made for fasting. One could argue or say that the benefits of fasting are because the body is anticipating starvation and upregulating all of these genetic changes to adapt and deal with not having food for a while. So, in that context, how does fasting become intuitive, and what I mean by that is, how do you know in a fast, timewise or hours-wise, when it is intuitive, when you should be fasting, and when you should actually be eating? How should we interpret hunger cues versus cravings? How do we know if we should keep fasting or not?

Dr. Will Cole: That's the part of the criticism, like, the critique, the pontification on social media is like, “Why is he giving us a protocol in a book that's called Intuitive Fasting?” I mean, look, I didn't realize this again, I'm so in my functional medicine clinical bubble, and the book came out. Part of it was the fact that Gwyneth Paltrow with the foreword of the book and Gwyneth Paltrow, a friend of mine, and a patient of mine and as I was involved with the book, and she's a lightning rod for these things anyways. I think I could have written a book about world peace, and there would have been negativity about the book, because people are just so triggered, or addicted to being triggered, just like they're addicted to junk food.

So, the reality is that I built the protocol in the book is to actually train that metabolism. Just like that yoga class, you have to gain some flexibility and strength and a mindfulness. Yoga is a mindfulness practice as well. The analogy works really well with intermittent fasting, because you have to gain some flexibility for just like the yoga practitioner, someone that does yoga, the yogi, it becomes their own practice. If you needed that beginning training at the beginning to become your own practice, and then you'll evolve intuitively that yoga practice as you learn about your body and get better at that skill set. That is exactly what's happening with intermittent fasting here. At the beginning, it will not be intuitive. The difference between hunger cues and satiety signaling and cravings, all of that will be disillusioning and confusing at the beginning. That's why I put the protocol together, so you can start to calm that noise, check in with your body, and so on a physiological level, what building the physical things like better blood sugar balance, lowered inflammation, better gut-brain access communication, better brain function, all that stuff's happening through beta hydroxybutyrate, and the pathways that are-- What researchers are exploring on these health benefits of intermittent fasting, we’re building that.

But on a mental, emotional, mindful, spiritual level, the books not just about intermittent fasting. Rather, I bring in what are called these metaphysical meals into the book, into the protocol and that's what I have my patients do as well is be more introspective on how food makes you feel, how does fasting make you feel Using food and fasting as a mindfulness practice, using food and fasting as a meditation, just like yoga, you're starting to get introspective on how food and fasting makes you feel. So, you're not just building the physiological stuff that we're building to the health benefits of intermittent fasting, but we're also growing awareness and mindfulness around these practices and around these tools.

So, the answer won't be clear cut at the beginning, but the more you practice this, the more you find that rhythm to your body, the more you're checking in with your body, checking in with your energy levels, checking in with your digestion, checking in with your sleep levels, your sleep pattern through the night, checking in with your brain function, all of these things you are-- These are aspects of mindfulness practice that I'm having person do through the protocol. Then, at that point, they're going to know, “Oh, I felt better when I did more of this. I'm going to do more of this type of fasting,” because each week in the protocol is a different type of intermittent fasting or time-compressed feeding, which is the specific subset of intermittent fasting that I'm exploring in the book. So, each week, you will have grown in awareness in how that time made you feel. And then you're going to be able to evolve that practice, just like a yogi can to suit your body. That's bio-individuality. We're all different. That's the heart of functional medicine.

So. people after maybe two or three cycles of the 4E protocol in the book will evolve intuitively to suit their body, because we are all different. Not everybody needs the same types of intermittent fasting. Maybe somebody needs the least amount for this season of their life like a 12:12 time-compressed feeding, which is very basic, it is very unsexy in the fasting world. But it's a great tool that some people can rest in for a while. So, that’s 7 AM to 7 PM, or 8 AM to 8 PM, you're eating and you're basically just fasting through the night until you break the fast at breakfast. That's a tool that we use in the book. Because that's a baseline for most humans to find, and then from there, you can expand and contract that eating and fasting window. So, that's how I see it, is that you will start to be more curious about your body, and more curious about how food and fasting makes you feel, and over time, that practice will evolve intuitively, because you're going to constantly be mindful about how these things made you feel. That's what intuitive fasting is about.

Melanie Avalon: It's such a complicated nuance. You just touched on all of it with intuition. You think, “Oh, if it's intuition, you should be able to just do it.” You shouldn't need rules, or instructions, or boundaries, but I was just thinking about it, so many things, you use yoga as an example, but so many things that we do as human beings, naturally, that is our normal capability for life, we were taught that by parents. It required some sort of teaching and guidance, even though it's “intuitive,” we're able to do it as human beings, walking, well, if reading is intuitive, but just so many things in our daily life. I'm just wondering, do you think if you had titled the book, something different, but had the exact same book, it wouldn't have received any backlash? Do you think it was just because it was called Intuitive Fasting?

Dr. Will Cole: That's part of it. Yeah, that's definitely part of the controversy. I think it was a mixture of me, someone outside in functional medicine, A. B, Gwyneth Paltrow, people, they don't even need to know any context. And then, C, the title of the book, and yeah, those are the main things. The reality is, I wouldn't change the book title at all, because I think it's a perfect symbol for what the book’s about, and in a way, I wouldn't change it at all. They were way more positive stuff than negative stuff. But that pocket of negativity wasn't even negative at the end of the day. I'm blessed and privileged to be able to write a book and have these conversations. I'm so thankful for it. It's a teaching moment to our culture that I think that has a lot of problems on many different levels when it comes to social media and how they talk to people, and how you would never say to them something like-- Half of the things that people said, they never say to my face, but they can just type and be keyboard warriors and these online trolls, and be negative. It doesn't matter to me. At the end of the day, I know what the book’s about, and I know, anybody that read the book will get the message. The reality is look at what's happening in our culture right now just on a health level. It's like, “Yeah, people are really messed up when there comes a relationship with food, and the idea that fasting could be intuitive, that's what's triggering you?” That just shows you where the state of the fragility of our culture. Talk about our privilege fragility that you can even have a book with that title, and it's so triggering to people. We have bigger problems in the world.

I think that when you really look at that, fasting has been used mindfully and intuitively for a long time. I'm just reminding people of our roots. Fasting has been used as a meditative practice in every spiritual tradition there is. It's used in Judaism with Yom Kippur and Tisha B'av. It's used in Islam as during Ramadan, people are Muslim just ending that around this time. It's used in indigenous cultures around the world. It's used in Christianity around Lent. It's used as a meditative practice for monks around the world. It's used as a spiritual practice. That's really what I'm talking about. It's remembering that these things, intermittent fasting, fasting is part of our DNA on a physical level, because from an ancestral health perspective, our genetics haven't changed in 10,000 years, but our world has changed very dramatically in a very finite period of time. And humans, because of food scarcity, would have evolved through times of fasting, and that's where a lot of the healing benefits can be upregulated, because we're decreasing the chasm between genetics and epigenetics. We're decreasing the mismatch between genetics and epigenetics.

So, yeah, that's on a physical level, the health science, the exciting health benefits of intermittent fasting, but look, fasting’s also encoded in our spiritual DNA because it's been used throughout time. No matter what ancestral connection you have, no matter where your ancestors are from around the world, chances are fasting was used intuitively for both spiritual purposes and health purposes. So, I'm just having a modern conversation about this topic, and we are so divorced from our roots as a culture, that me just reminding people of where we came from is triggering for people. That says more about our culture and the state of where we're at that fasting and healthy food that is in alignment with our physiology, and in our DNA, the fact that that's offensive is more of a statement of where we're at as a culture and how far we've removed ourselves from our roots.

Melanie Avalon: I mean, you just spoke a lot about change. I just finished reading Dr. Robert Lustig, his new book, Metabolical, which is all about the processed food industry. I never want to eat processed food ever again. But one thing he talks about in that book is, what is required for change in a culture, and he talks about education alone doesn't work, there has to be some implementation beyond that. Your book is education, it's educating so many people on the situation, and how to change yourself with these plans, and these dietary changes, and these mindset changes. How do you feel though about making lasting change, and this is a side note, tangent, but lasting change in the culture from a regulation perspective? So, in the processed food industry, do you think that there should actually be regulation there, or that we should fight to not have these types of foods available, or do you think it should be more up to the individual and that we shouldn't really address that?

Dr. Will Cole: Well, I'm coming from a functional medicine clinician’s perspective and obviously, I'm giving my clinical opinion, my personal opinion, too, and by no means am I a policymaker, or know the ins and outs of the unintended consequences of certain things from a policy standpoint. I'm not going to pretend that I know all of that. But coming from my side of things, someone that's been in the wellness world for a long time, somebody that does this 11 hours a day consulting people about these topics, I don't know if overt regulation is really the answer. I think you can look historically and say that, even if you look at prohibition with alcohol, is that really outlawing sugar? Is that really the solution? Maybe it's not going to be that extreme, but putting government involved with the junk food industry fully, I think there's a middle ground. I think more than anything, what has to happen is education has to be empowerment and transparency. That's the problem. I don't know if more regulations are the answer. Some maybe, some logical, practical, measured things make sense, maybe. But I think more than anything, people need to be educated and empowered and informed. They need to be able to see clearly and plainly what these things are.

So, maybe it's a warning label in some of those foods. Maybe it's very clearly, “Hey, if this is your choice, if you want to buy this, you can purchase it, but this is associated with this,” maybe it's that or maybe it's no warning label, maybe not something that extreme, maybe it's just really empowering people or even a color-coded system of green, yellow, red of things that are more prone to driving metabolic issues. If you want to buy it, you can make that choice. I think changing the hearts and minds of people, I think, is where the solution is going to lie, not in controlling industries like that. Even though I know the industries are corrupt, and I know they are making these designer foods and make them addictive, and they are cheap, which is completely messed up, but look, why are lot of these junk foods and fast foods cheap? It's because of government subsidies and the way that the system works, so the governments already involved, and they're making these things really cheap for people. So, I think that probably the answer is educating and empowering people and transparency so that people actually can make that choice for themselves. That's what I think. I would say, coming from a functional medicine perspective would be my instinct. But obviously, I'd want to look at both sides. I know that's a new thing to some people, but I want to look at both sides and see the variables at play here.

Melanie Avalon: The transparency issue is so, so important. If you think about it, there have been changes in things where at the time, probably people would have never anticipated there being a complete 180 on smoking or wearing seatbelts. Education and transparency did happen with that. So, I'm hoping with the processed food industry that there's that potential. It does bring up another nuance, which also relates to something in your book, though, because you were talking about the potential for a food rating system. So, a color or saying, what is the metabolic health issue potential in this food, there's so much debate surrounding, what is healthy? Oh, my goodness. So, for your approach, your first book, I said was Ketotarian, you do talk about the Ketotarian approach in your new book. So, when it comes to health, what are your thoughts on plant based versus animal-inclusive diets? What made you gravitate to a Ketotarian approach? I know my listeners ears are going to perk up, because I think a lot of people, especially in the low-carb community think that that low carb automatically means high animal protein, and it means less plants but you have an entire Ketotarian approach. So, what are your thoughts on all of that?

Dr. Will Cole: I want to echo what you just said. If it was me running the world, and getting colored system, green, yellow, red, it would be fine. But in a diverse culture with free thinkers and different opinions, you probably couldn't do that the color-coded system, because not everybody's going to agree unless there's some basic tenants that everybody agree like maybe too much sugar, processed sugar isn't good for you, maybe we could agree on that, and maybe that's what the red, yellow, green would be like. The more sugar, it would be in maybe we could show it clearly in some way. But the debate, when it comes to labeling is saturated fats, and even industrial seed oils, people are going to debate about those things. So, I don't know if you're going to get a cohesive-- and that's what I mean. By no means, am I a policymaker and understanding that, I just want to empower people. I want to educate people. I want people to know about their bodies, and know how foods impact their physiology.

So, I can change the hearts and minds with my patients and with people that read the books or people that listen to my podcasts or people that check me out on social media. That's my goal. Because I don't know if a system-wide change like this is really going to happen in a way where everybody can agree. Because you get special interests involved, and they're going to demonize whole macronutrients and make broad-sweeping, overgeneralized statements where nuance is lost and context is lost. Fats are demonized in that way, where the nuance and context is just completely lost. So, Ketotarian, it's my made-up word again. I think in hindsight, when I look at the things that I write about, I'm drawn to paradoxes, mostly by plant based in keto and intuition and fasting, and I think that this is something that I really see work with people. People that take two seemingly opposite things, they get the best of both worlds without falling prey to the potential pitfalls of being all in, in one way without looking at that context and nuance. How do we do this from a sustainable health standpoint? So, what Ketotarian really is, is a Mediterranean, pescatarian, plant-forward ketogenic diet. So, it's not entirely vegan. It's not entirely vegetarian keto either. It is more what I call in the book “vegaquarian.” It's wild-caught fish, its fresh seafood, lots of vegetarian options too like eggs, etc. and lots of plant fats like olives and avocados and non-starchy vegetables. So, that's what Ketotarian is.

That's one of the reasons why I wrote it in 2018 is because there was that massive keto conversation that was happening and I had cohosted Keto Talk for three years, and I really wanted people to have this different approach, or even if they weren't going to be entirely Ketotarian, they could at least have some pescatarian keto, vegetarian keto and vegan keto options in their omnivore, clean, well-formulated nutrient dense ketogenic diet. So, I was a resource for people even if they weren't strict Ketotarian, and the book isn't strict anyways, and I talked about that in the book, and none of what I do is really dogmatic, because I want this to be flexible and approachable to people, and I talk about in the book, how I bring grass-fed beef and I'm omnivore. I just wanted it to be a resource for people to utilize in their life.

There are some people that just prefer eating pescatarian, or prefer eating more vegetarian. So, I knew from the plant-based community, so many of them were carbitarians, depending on carbs and sugar for fuel to say, look, if you want to be more plant based, let's do it in a way that's not going to wreck your metabolism, that's not going to wreck your gut, going to really not wreck inflammation levels and support all these healthy balance pathways in the body. So, that's really what Ketotarian is all about. Even in Intuitive Fasting, there's many omnivore options in that book. I'm not against people eating good grass-fed beef. I love Belcampo, and I love these brands, these farms that are coming out with really good regenerative farming, and they're the wave of the future. They are going to save the planet. Regenerative farmers are going to save the planet if we listen to them.

So, I'm not against meat. I just think there has to be a nuanced conversation about this, because the problem that I was seeing in the keto community in 2017, and in 2018, and even before that, is that they were high fat, low carb at all costs. If it was hashtag keto, if it was low carb, they were going to go for it. Anything that lowered ketones was seen as this devil, and you should fear it. You had a big sect of the ketogenic community at that time, and even today, they get caught up in fearing vegetables and fiber. I know from a functional medicine standpoint, that gut microbiome diversity and fiber has its place and should not be feared for the average person. So, I think that can create some unintended consequences when it comes to orthorexia, which I think is rampant within the low carb and ketogenic community, or they become fearing real foods.

Look, there's a time and place for higher ketones. If you have a neurological disorder, if you have a seizure disorder, if you have different autoimmune problems that you're using higher ketones to attenuate those responses, you're using the therapeutic benefits of higher ketones, and you need that, of course, that we need to look at those things. But the average person that's just looking to feel great, optimize their brain, optimize their energy levels become metabolically flexible, keep inflammation levels balanced. I don't know if long-term health, you becoming obsessive about macros is really the answer. I think it's a matter of really having this flexible tool within the toolbox and not feeling like you have fear and dread over fiber from vegetables. So, that's really what Ketotarian was the conversation that we're having in that book.

Melanie Avalon: I am so passionate about the importance of regenerative agriculture. So, I just wanted to provide a resource for listeners, because you mentioned Belcampo and I've had Anya Fernald on the show. So, I'll put a link to an interview I did with her, and I've also had Robb wolf on for Sacred Cow. I'll put a link to that just further education for listeners who want to learn more about the implications of regenerative agriculture on not only our health, but the environment and our entire world. Then, something else that I wanted to touch on, the concept of ketones and people just freaking out about ketones, I just recently learned that the whole idea of nutritional ketosis and the ketone level that's associated with that was basically from one study in the 1980s, I think Phinney and Volek, it wasn't looking at long-term people on ketogenic diets.

So, we don't necessarily know-- although there's a lot more data on it now, just people sharing their data, but high ketones that might be for a lot of people transient and higher in the beginning of a ketogenic diet or in fasting, and there's quite possibly the potential that the longer you're doing fasting or a ketogenic diet that your blood level of ketones might not be as high, and I just think it's one of so, so many confusions in the world, where people get these ideas that are talking to very nuanced complex systems in the body, and they get synthesized down into this one idea that people just grab on and I think it's doing so much detriment, so, sorry, that's a soapbox. [laughs] They just really appreciate.

Dr. Will Cole: Yeah, it's important. I want people to have-- If what you're doing is working for you, keep on doing it. That's what I'm talking about. I'm talking about the vast amount of people that don't know these amazing tools exist, and I want to empower them to lean into this, or the people within the community, where may be what they would did worked for a time, but then they get unstuck, and they're like, “Whoa, I have to pivot. But if I pivot, I'm a failure.” Or, “If I pivot, I'm like, everything I thought was true for my health isn't.” So, it's okay to evolve. It's okay to pivot. It's okay to experiment. It's okay to ask questions and what served you at one point in your life isn't necessarily what you needed to do forever and ever. So, that's the variability, and the variety that I tried to put throughout all my books, because that's clinical practice. That's what 12 years of talking to people all day long has done for me is that if you hung your hat, on one way of doing things for everyone, or if you hung your hat on one way of doing things for you for the rest of your life, you're going to be proven wrong. It's just a matter of when, not if. You have to be comfortable with asking questions. You have to be comfortable with evolving, and that doesn't make you a failure, and you cannot shame and obsess your way into health in this way. It's unhealthy. Because that stress and anxiety of unhealthy foods, we why the heck are we even doing this, if it's such a source of dread and obsession?

There should be an art to wellness, and that's why even when I call my podcast that, it’s The Art of Being Well. It's like, let's just get out of the obsession and into the art of-- So, that I think Inflammation Spectrum, but is that wellness is sacred art, you are the masterpiece. I think if people started seeing themselves as a work of art instead of this machine that they have to obsess about, I think it'd be so much more enjoyable for people and more sustainable.

Melanie Avalon: I haven't really thought about it this way before, but when making a dietary change, trying something new is scary, but I think the scariest or the hardest part for so many people, I know for me, is just letting go of something that was working for you, because we just feel like, if it was working, it seems safe and it feels like it should keep working, and it can be so hard to let go of the idea that maybe this isn't working anymore. Still accepting that it did work at one point, because it can feel like a failure. If you can feel like, “Oh, maybe it was never right for me, but maybe things have their time and place.” Something I'd love to briefly touch on, because you touched on the microbiome and the role of gut health. I just wanted to touch on two really fun little things that I learned in your book-- not little, but two things in your book that I learned that I had never, ever heard before that really blew my mind. One was that, you talked about how in bariatric surgery, it's been posited that the weight loss actually is from shifts in the gut microbiome. I had never heard that.

Dr. Will Cole: It's powerful. I think if you look at the causation, the causative facets to fasting, and the impact that has, what researchers are exploring are the gut-centric changes that are happening there, and that being a major part of the health benefits. Yeah, studies have also shown that with gastric bypass bariatric surgery on the same thing, is when you change someone's microbiome in a significant way, what that can do to someone's metabolism, and also their mood in their brain and hormones, and so many other things. It's such a major facet of my work, so I found that study really compelling. Obviously, over time, I'm excited for the other-- more studies come out and that avenue to really look at the gut piece of the puzzle. It's not just about digestion, which is obviously that too. I mean, that's why there's studies to show people that have all colitis, or Crohn's or different inflammatory issues, even IBS, that intermittent fasting can be good for those people, which is great. But what else is going to happen, when we regulate the gut. It's not just improved bowel movements, it's going to impact your metabolism, impact your brain, it can impact inflammation levels, it can impact so many other things. So, the possibilities are endless when you start improving gut health.

Melanie Avalon: I feel like the two biggest chasms in our present planet where we just don't know what's down there would be probably the depths of the ocean and then our microbiome. [laughs] Then, the second other gut thing that I learned that-- I don't know how I never came across this anywhere, because I'm a little bit obsessed with gluconeogenesis, just the concept, like [laughs] when it happens? why it happens? Is it stressful? Is it non stressful? Is that a good thing? Is it a bad thing? I learned that there's a different type of gluconeogenesis that occurs in the intestines, intestinal gluconeogenesis, and it actually decreases blood glucose? I was wondering if you could talk at all a little bit about that.

Dr. Will Cole: Yeah, I wrote this section around fiber, actually plant fiber. So, there's two main different types of gluconeogenesis for making new glucose that are being explored. Hepatic gluconeogenesis is what we typically hear about within the keto community, or the fasting community with protein moderation, specifically within the ketogenic community, is that's why you don't want to do a high protein diet for long-term, because of the impact that gluconeogenesis could have on blood sugar and ketone levels. That's why ketogenic diet is high fat, moderate protein, low carb.

Now, obviously, a lot of people within the carnivore community or a carnivore keto community, they're going to say that protein moderation is not that big of a deal. It's really the carb restriction. I would agree with that for most people. But if you're looking at mTOR, and a lot of the longevity benefits, and the anti-cancer benefits of the ketogenic diet, and intermittent fasting, which, ketogenic diet for all intents and purposes is mimicking a lot of the same benefits of fasting, because both are supporting beta-Hydroxybutyrate, all the benefits of that comes as an epigenetic modulator.

But intestinal gluconeogenesis, and it's made through eating plant fibers has a glucose lowering effect, and they go over the studies in the book. The fact that overall, for most people, it's going to help lower serum glucose, and it's also going to lower insulin resistance and improve increased satiety levels, meaning you're not going to feel hangry, and have insatiable cravings. So, that's why one of the reasons why I don't want people to become overly jealous and obsessive and orthorexic when it comes to a salad or that non-starchy vegetables, or fiber-rich vegetables, because the net carbs, when it comes to these vegetables are really low. But if you look at total carbs, you're going to think, “Dang, if I'm having 20 grams of carbs in a day, how the heck am I going to have vegetables?” Or, even if you're a little bit looser, go to 30, 40 grams of carbs, “how the heck am I going to have vegetables?” So, I talk about the context matters here. The context around carbs matters, and lumping all carbs and behaving the same way in the body is just very oversimplistic, very reductionist, and it doesn't look at the nuances of how these carbohydrates which fiber, by its very definition, is a form of carbohydrate, how do these things behave in the body? Well, fiber behaves very different in the body versus can of soda. So, I want people to be mindful of that.

Melanie Avalon: I love it. Always back to the nuance. So, maybe something that we can end on that is a more fun topic than dealing with all of the issues of our current culture. When it comes to fasting, something that we talk about a lot on the Intermittent Fasting podcast is the whole idea of clean fasting, and what you drink during the fast, and there's a whole world of debate and nuance there. But you have an epic, epic section on tea, and it sounds like it's really a passion of yours. So, I was wondering if you could just tell listeners a little bit about your favorite teas or teas that they might like to drink while fasting, because I didn't realize-- I remember when I first learned that all tea is the same thing, and that  it's all the same plant that blew my mind. [laughs] I was like, “What, I feel I've been lied to my whole life?” So, teas.

Dr. Will Cole: [unintelligible [00:53:16] So, the reality is I am kind of a tea aficionado. I am obsessed with it. When I was writing the book, I remember exactly where I was. basically, I've a very visual memory. When I was writing, I was sitting on my deck, this is over 2020, this is the height of COVID. I'm writing about tea, and I thought, this is so-- I'm so pumped about putting this section in the book, and the publisher is normally always on the same page as me and I'm like, “Okay, I wonder what they're going to think about this.” But it's within the toolbox chapter, I think is that where we put it is that the reality is like, it's such an awesome fasting drink. People are always asking me, both the patients and people on social media, what breaks a fast? Of course, there’s diverse opinions about that everything else, but the reality is, I think tea is a great tool, because even if certain teas don't work for you, there's so many-- there's a myriad of different players within the tea kingdom that people can experiment with. So, you're right. Camellia sinensis is the main type of tea. That's the tea, the plant that makes green tea, black tea, white tea, oolong tea, Pu-erh tea. So, that tea, and they're different, like, how you can get green, white and black and all the different types of black and green and white is because it's how it's grown, when it's picked, where it's grown, in the shade versus in the sunlight, where it's picked, how it's processed after it's picked, if it's laid out in the sun, if it's fermented, if it's roasted, that's what makes all the types of green, white, and black tea.

So, I include all of those different ones with the research around those in the book. Then, all the tisanes, the non-caffeinated-- They're not even true teas. They're just things like Rooibos or African red bush, hibiscus tea, all the herbal teas out there. So, I wanted people to have variety and be able to pick and highlight these different, amazing, exciting health benefits of these and experiment with them. Because they all have their own strong suits, they all have their own benefits or highlighted things that researchers are exploring with. Depending on the things you want to focus on during your fast, you can bring some of that in. Tea has also been used as a meditative, introspective, intuitive tool as well, and I talked about that of using one of those metaphysical meals, like, what do you do when you're fasting can be a mindfulness practice around drinking tea, which I think is really beautiful to and from China, and North and South Korea and Asia basically.

So, it's a great tool. I love using it. I have it when I'm fasting or I'm not fasting. But specifically, when you're fasting, I think it could be a great thing, and I even talked about the research around Earl Grey, which is probably my favorite tea, but it's a black tea with bergamot in it. Bergamot is a citrus from Calabria in Italy. It's been shown, the polyphenols in bergamot, it's been shown to increase autophagy pathways, or cellular renewals sort of-- People know about this, but anti-accelerated aging pathways, but fasting does that as well. So, I oftentimes will have a tea with bergamot in it. When I'm intermittent fasting, and we actually partnered with Pique tea, which if you don't know about peak tea, they're freaking amazing. Simon Chang's a good friend of mine, and they have a Dr. Will Cole Fasting Tea Bundle, we have at drwillcole.com with some green fasting tea, but then herbal tea too for people some people that are sensitive to caffeine, but all the teas are higher with the bergamot in it, which can help with the autophagy, but it also improves, increases satiety signaling, so, I can make your fast easier as well, and then you get all the therapeutic benefits of it as well.

Melanie Avalon: See, even right there, the nuance, because I asked for questions for you, for the show, and somebody asked about the tea, and then they showed me a study that showed the complete opposite of what you think. It showed that tea actually led to more insulin release, unless you added dairy to it, which I'm not saying that to have a whole debate about that, just to show that everything is always so nuanced, and there seems to be so many things going on. I guess that's why it's really hard to find clarity with everything, but teas do work.

Dr. Will Cole: If one tea doesn't work for you, it doesn't. Because I've seen studies too, and people talk about that. But look, that's like saying, cortisol is raised during your fasting. So, you shouldn't fast. That's silly. The context is lost. It's a hormetic effect, fasting is. So, before, fasting is not good, because it raises cortisol. Well, yeah, because part of the actual benefits of that, the body's doing a symphony of different cascades. The fact that a drink can raise insulin a little bit isn't a bad thing. That goes back to the earlier point is that we think the body so static, and raising insulin is a bad thing, well, it’s not. The body's doing a lot more than that, and context matters and looking at glucose, looking at ketones, looking at insulin, looking at all of this, and looking at how the person feels, when they do that all of that matters and isolating one biomarker and saying that's bad, it's again reductionist, but I get the point. But if something doesn't work for you, if you don't like insulin raising a point or two, then go to a caffeine-free tea. There's many options out there.

Melanie Avalon: 100%. Are you considering writing a tea book?

Dr. Will Cole: Oh, man. [laughs] Maybe, I don't know. Over this year, and probably next year, I'll be working on my fourth book. So, we'll see where the pen takes me. I don't know yet.

Melanie Avalon: I'm so excited. I’d love to bring you back for that. Well, thank you, Dr. Cole. I was just thinking about it. I’ve had so many conversations about fasting in my life. By the time this airs, it will probably be almost 250 episodes on the Intermittent Fasting podcast. I can honestly say, this conversation just now was one of my most favorite conversations I've ever had about fasting. This was just amazing. It's going to stick with me. I can't wait, I want to air it right now. I want to be like, everybody, listen, right now. So, thank you so much. I know that you had all the controversy, and I just really, really appreciate your approach and everything that you're doing. Given all the controversy and all that, was there anything else you wanted to emphasize for listeners?

Dr. Will Cole: Well, no, I think maybe context with that matters, too. I said this, but I'll say it again, is that there was 99% so much positivity in the book. The book hit the New York Times bestselling book. That means people bought it. [laughs] People that hated on the book, didn't buy the book, but you know what they did do, they really helped the algorithm, so, I have to thank them, because actually helped more people hear about the book, and read the book. So, it's positive. It's all positive. What was born out of that small sect of people that are toxic tribalist people-- and they're in every group, they're in the wellness community, they're in political stuff, they're in everything. It is what's happening with our culture right now. It doesn't really matter at the end of the day. People that know what we do, people that know what we’re talking about understand the message that we're talking about, it's a positive thing. Getting people healthy is a positive thing. I'm still happy that the people at the end of the day are loving the book, and thank you for the opportunity.

Melanie Avalon: No, of course, thank you so much. You might remember this from our last conversation. But the last question that I ask every single guest on the show, and it's just because I appreciate so much, and you talk about this all throughout the book, about the role of mindset. So, what is something that you're grateful for?

Dr. Will Cole: I don't remember what I said last time, but I'm pretty much a routine person. We have a gratitude practice every day. Before we're consulting patients online, we go over case reviews, but we also start with the gratitude practice even before that. We do prayer and meditation as a team, and it's really a cool time. So, I'm grateful-- I probably said, my wife and my kids last time because I am eternally grateful for my wife and my two kids. I'll say something different because I normally don't say this, but I am extremely thankful for them, is my team. My team is amazing, and a lot of them have been with me for 8, 9, 10, 11 years. So, most of my career, they've been with me, and we're just an awesome, well-oiled athletic team, meaning that we're responsive, and we love our patients so much. I couldn't do it without them. They run the clinic with me and help me manage all the cases and even the podcast stuff. So, getting all that stuff organized, I could not do it without them. So, I'm thankful for them.

Melanie Avalon: Awesome. Well, I love that so much. Again, listeners, I'll put links to everything in the show notes, any other links that you want to put out there for people to best follow your work.

Dr. Will Cole: Thank you.

Melanie Avalon: All right. Thank you.

Dr. Will Cole: Awesome.

Melanie Avalon: Bye.

Dr. Will Cole: Bye. Have a good day.