Podcast transcript

INTRO
Welcome to Docs in a Pod, presented by WellMed. Over the next half hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-hosts Dr. Rajay Seudath and award winning veteran broadcaster Ron Aram will share information to improve your health and well-being. And now here are Ron Aaron and Dr. Rajay Seudath.

RON AARON
Hello there and welcome to the award winning Docs in a Pod. I'm Ron Aaron, and we come to you every week with a look at a variety of health and social issues that affect people 65 and over, or anyone else for that matter. Our co-host, Dr. Rajay Seudath is with us. He's also our guest today and we have a fabulous topic. Dr. Seudath is board certified in family medicine. He's a Tampa native and a current lead physician for Optum. Dr. Seudath, it is great to see you. This is a wonderful topic. We're talking about intermittent fasting for people 50 and over. A lot of folks want to know does it work and is it safe?

DR. RAJAY SEUDATH
Yes, yes. It is an interesting topic. Intermittent fasting in the last few years has garnered a lot of attention simply because it does work. If we had to ask, does it work or does it not work? The short answer is yes. That has to do with any type of diet. Any type of dietary restriction decreasing the calories that you're taking, all of them work if you stick to it. That's number one. If you are maintaining less than 2,500 calories a day, any of them are going to work. Now, intermittent fasting. Why does that work? That seems to work because for whatever reason, people can wrap their head around the idea of, I'm not going to eat it this time. I'm going to eat it this time. I'm not going to eat at this time. I'm going to eat it this time. I'm not sure the psychology behind it, but there's an idea where the major problem of losing weight is, I'm hungry. I'm starving. My body is telling me I'm in a famine. I have to find food now. Intermittent fasting kind of takes that right on the face and it says you're going to be hungry for X amount of time. Deal with it. When you put that at the forefront, I think when people know there's going to be feast and famine times, they're able to wrap their heads around it.

RON AARON
Now, intermittent fasting comes in various forms. It can be eating certain times in a day or not eating from one day to the next.

DR. RAJAY SEUDATH
Yes.

RON AARON
For someone who is Jewish, on our most serious holiday of the year, Yom Kippur, it's a day of fasting.

DR. RAJAY SEUDATH
Yes.

RON AARON
I gotta tell you, it's the toughest thing in the world not to eat for like, 12 hours.

DR. RAJAY SEUDATH
That's correct. Sometimes all you get is Matzah and things like that. You're absolutely right. Intermittent fasting comes basically in two flavors. The first one is kind of, I'm going to have fest days and I'm going to have famine days. When they did studies, they basically say 25% of your daily needed calories, that's going to be on your famine days.

RON AARON
So, you still eat a little.

DR. RAJAY SEUDATH
Right. You still eat a little, but you're going to eat far less than what your caloric needs are for that day. Then on the next day, you can have 125%. So, you can have a feast day and then a famine day and a feast day then a famine day. As you do that, it actually comes out to 150% instead of 200%. So, you're actually getting a lot less of that. You're decreasing your caloric intake by 50%. So, that's the idea. You want to be below that caloric intake. On a week-to-week basis, it's allowing you to do that. That's one way of doing it.

RON AARON
How do you lose weight?

DR. RAJAY SEUDATH
The weight part, and this is kind of interesting. The weight part is pure math. Any scientist, any doctor, any hard-nosed science person will tell you it's not that hard. These people are making it too much of an issue. It's just you gotta eat less than you burn off. And it's easy to say that, right? The math is the same. Two plus two is always four. You can't get around that. The reason why it works is you get less than that 100% of your daily value.

RON AARON
Hold that thought. IÕll come right back to you. We're talking about intermittent fasting, how it works, why it works, and could it be for you? I'm Ron Aaron. You're listening to the award winning Docs in a Pod. Our co-host, Dr. Rajay Seudath is with us. He's also our guest today talking about a topic that's very much in the news. In fact, Dr. Seudath, I was mentioning to you off the air, that the star player for the Lakers who used to be with Dallas, Luka Don?i?, was a little tubby guy when they traded him to the Lakers from Dallas. A lot of criticism. This past summer, apparently, and there are photos of the new slimmed-down fit as can be Don?i?. He did intermittent fasting and man, it worked.

DR. RAJAY SEUDATH
Yeah. The type of intermittent fasting he did was what's called time restriction intermittent fasting. Time restricted feeding is there's a certain period of time where I can eat, and there's a certain period of time I cannot eat.

RON AARON
MineÕs 24/7.

DR. RAJAY SEUDATH
IÕm on a seafood diet. Every time I eat seafood, I eat it.

RON AARON
Right.

DR. RAJAY SEUDATH
For Luka, his was a 16-hour fasting time, and an eight-hour eating time. And that's pretty standard. So, you pick an eight-hour block say from 12 p.m. to 8 p.m. That's the time I can eat. Again, even within that, you're still trying not to go over your daily limit. You're not trying to go over the 2,500 calories. But the idea is I'm not eating just before I go to sleep, unless I'm going to sleep right at 8 p.m. I'm letting my body get into a fasting state by not eating early, early in the morning. Like right when I wake up from my fasting sleep, I'm not immediately putting calories in my body, right?

RON AARON
Yeah, but youÕre hungry.

DR. RAJAY SEUDATH
Of course. That's the kind of the beauty of this system. It really just tells you you're going to be hungry. Deal with it. Again, whether it's Sugar Busters or Weightwatchers, there are other different systems involved, and they come up with many different ways to offset the hunger. That's really what all of those systems are trying to do is trying to allow you to eat less and not feel as hungry. Whereas intermittent fasting kind of does the opposite. It says you're going to be hungry. We're not going to lie to you. This is how it's going to be. Deal with being hungry. I think for a lot of people, that has been a major change in the idea of losing weight.

RON AARON
So, what happens when someone like Don?i? loses a ton of weight? He gets all sculpted. He looks fabulous. But for almost everyone who goes on a diet, it's like playing with a yo-yo. You put it all back on, right?

DR. RAJAY SEUDATH
Absolutely. There are studies that show people who lose more weight in that first year have a higher rate of keeping that weight off right. So, people who make very, very slow, modest gains tend to put those gains right back on. I think it just has to do with that building steam and really making those lifestyle changes. The idea is I did this intermittent fasting for a year. I stopped doing it and now I put it all the way back on. For some people it may be, I continue to do intermittent fasting, and my caloric intake is now 3,000 calories instead of 2,500. Or it could be I do intermittent fasting a few days a week, and I still have my other days, and that allows me to plateau to kind of normalize my weight.

RON AARON
How do you know what works for you? Is it trial and error?

DR. RAJAY SEUDATH
It's going to be trial and error. I'm so glad you brought that up. How do we ever measure our successes? There's a saying, ÒSuccess is a state of mind.Ó Yes, that's true, but really and truly, you measure success by the numbers.

RON AARON
And the bathroom scale.

DR. RAJAY SEUDATH
Absolutely. One of the things, it's called, SMART goals. Specific. Measurable. Achievable. Reasonable. Time bound. Part of the psychology of weight loss is monitoring yourself. You are keeping yourself accountable because you can say I'm going to diet all I want, but you yourself know at 3 a.m. you're defrosting a frozen pizza and you're eating it all by yourself.

RON AARON
On the floor in the kitchen.

DR. RAJAY SEUDATH
Right. That's not being accountable unless you write that into, well, I had 1,000 calories at 3 a.m. today, I only got 1,200 to play with for the rest of the day. So, that's one of the ways that you can do that. That's exactly what you're talking about.

RON AARON
You raise a good point. If I understand you correctly, on this intermittent fasting diet, it isn't necessary what you eat. You can eat high caloric foods, but you're looking at a ceiling in terms of caloric intake.

DR. RAJAY SEUDATH
Absolutely. That's what we get into, are you hungry or are you not hungry? Certain foods that are high in calories are not satiating. You eat a Twinkie, it's high in calories, but you still feel hungry.

RON AARON
Hold that thought. We're going to get right back to you. We're talking with Dr. Rajay Seudath. We're talking about intermittent fasting, a way in which we can take the weight off and make it work. We're going to talk as well about folks who may be older. Is it safe for them as well? I'm Ron Aaron. We're delighted to have you with us on the award winning Docs in a Pod.

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RON AARON
How's your weight? Have you thought about intermittent fasting? I'm Ron Aaron, and you're listening to the award winning Docs in a Pod. We're talking about intermittent fasting with Dr. Rajay Seudath, our co-host and our special guest today. If you're older, is intermittent fasting okay.

DR. RAJAY SEUDATH
It is safe to do. Intermittent fasting again, which is either eating less amounts for one day and alternating to a normal amount the next day, or restricting the time frame that you're going to eat to an eight-hour block, say from 12 p.m. to 8 p.m. Within those parameters, it is safe to do. That being said, certain disease states do have a little more risk to them. So, for instance, if you are a diabetic and you are on insulin and you're taking your insulin three times a day and you're only eating for an eight-hour block, that could drop your sugars potentially. So, it's important that we tailor your diet to your disease state. That should be between you and your primary care physician, or you and your dietitian to make sure that we're keeping you safe. For instance, in the case of diabetes, you're making sure you're checking your sugars three times a day. Or if we have a continuous glucose monitor like one of the Dexcom or the freestyles or any of those other ones, you have that on and you're able to monitor your sugars should they go too low. That's one thing.

RON AARON
Not everyone has a dietitian.

DR. RAJAY SEUDATH
Right. That's one of the things that most insurances will pay for some sort of dietitian or nutrition visit. Sometimes it has to be linked to diabetes. Sometimes it has to be linked to obesity. So, you have to have a certain amount of weight for them to want to pay for it. You have to have a certain amount of disease for that one to pay for it. Another disease stick would be high blood pressure. If you are intermittently fasting, that does not mean dehydrate yourself. Just because you're not eating food for 16 hours doesn't mean you can't drink water for those 16 hours. So, I always try to make that differentiation. When you're doing intermittent fasting, it's not like you're fasting for labs where it's nothing per mouth, right?

RON AARON
Water can also make you feel full.

DR. RAJAY SEUDATH
Absolutely. It has to do with stretching the inside of your stomach. You can't see but I'm making a motion of ballooning the inside of your stomach. Fill yourself with water, when it mixes with the food, the food expands in your stomach and it kind of builds satiation. That's one of the things if you're doing intermittent fasting and you're taking your blood pressure medicines on an empty stomach, that may lower your blood pressures a little bit too much. So, when we're changing our diets, we need to be cognizant of things like blood sugar, our blood pressure and our heart rate. We should be checking our actual weight itself. Those are kind of doing a set of vitals once a day and writing them down. That's part of that self-monitoring. That's part of that keeping accountability. That's a whole issue that is very, very good at positively reinforcing the weight loss.

RON AARON
I want to pick up with something you were talking about Dr. Seudath. If intermittent fasting is something that can help you lose weight, is it something that you need to do for the rest of your life or can you go back to eating on a normal basis?

DR. RAJAY SEUDATH
The answer, as always, is it depends. Was normal for you I'm going to have a steak and potatoes every single day? The answer is no. If you're going to do that every single day, you have to do some sort of intermittent fasting or caloric restriction. The idea behind intermittent fasting is to decrease the amount of calories consumed. When you have met your goal and you're going back to, well, I'm going to eat three times a day, not on an eight hour span, the key thing is to continue is to not go over that 3,000 calorie restriction or whatever we calculate your daily needs are. When you go over that daily need, that's when you're going to get more of that weight gain.

RON AARON
So, it's helpful to read labels?

DR. RAJAY SEUDATH
Yes. Absolutely It's so interesting that for the longest time people didn't read nutritional facts. You just take it at face value. Well, this is food. Let me eat it. As we've gotten to the modern age and we realize that processed foods are not necessarily made to make us healthy and have longevity and have wonderful lives. They're actually made to make money. So, you can still have those kinds of processed foods in your life but know that those are processed foods. Those are empty calories. Those are not the whole, nutritious vegetables, fruits and meats that you are preparing. That was one of the things that I had researched. Portion controls, meal planning, actually doing the preparation of your meals is part of the way of being more conscientious of what am I putting in my body? If it's just the bare minimum of, like you said, reading the nutrition label, that's kind of the bare minimum. This is not good. Let me look at this one. This one has less salt. That one's better for me. That is what we consider the bare minimum. But it does make a difference for your health and for your diseases.

RON AARON
It's interesting you mentioned salt. I have religiously tried to cut down on salt for a variety of reasons. The other day I was in a grocery store in the salad and meat section. You can get a sample to see if it's something you like and I love shrimp salad, so I said can I have a little taste? They handed me a shrimp, and I took one bite, and I said, wow, this is loaded with salt. You know what the clerk said? Oh yeah, everybody says that.

DR. RAJAY SEUDATH
Oh, wow. Really?

RON AARON
Instead of fixing it.

DR. RAJAY SEUDATH
That just goes to the point. We're trying to sell shrimp here, buddy. That's the idea.

RON AARON
I didn't buy it.

DR. RAJAY SEUDATH
That was good. That was very good self-control. Maybe you have to make your own sometimes when you get more health conscientious like that. One of the things I did want to bring up when it comes to weight loss, this is kind of just a piece of trivia, but where does fat go when you lose the fat? When you do the intermittent fasting, when you do the extra exercise, when you're cutting down your calories below 2,500, when you are losing the weight and you're losing the belly fat, where does it go?

RON AARON
It drains out of your big toe.

DR. RAJAY SEUDATH
I've heard so many answers to this, but they've done studies where they have radioactively tagged the fat, and they have seen where it is liberated and with the organic chemistry. Every time you are exhaling, that's that beer belly.

RON AARON
Are you serious?

DR. RAJAY SEUDATH
Yes. Fat is basically carbon, hydrogen and oxygen. And maybe nitrogen at the end. Well, that carbon hydrogen oxygen is CO2 and water.

RON AARON
You mentioned belly fat, which supposedly is the worst kind of fat you can have.

DR. RAJAY SEUDATH
Yes.

RON AARON
When you go on this intermittent fasting diet, how does it know where to lose the fat? Does it lose it in the belly, or does it end up losing it in your legs, in your arms and everywhere else?

DR. RAJAY SEUDATH
There are people who can say that you can try and sculpt where it's happening. I'll just do a bunch of ab crunches and then my stomach will go away. That's not entirely true. In order to lose weight, you have to be below that certain amount, which is usually 2,500. Once you're below that amount, if you are using more of your muscles in that area, it would seem that that area would use up the fat for an energy reserve. So yes, if you're targeting your exercise to that area, it can help you to lose that belly fat. The second thing is intermittent fasting can use a type of metabolism which is called ketosis as opposed to regular metabolic, which breaks down sugars, ketosis can break down fats. So, when you do intermittent fasting, it can absolutely target fatty areas. So, it may target your stomach, it may target your legs, it may talk at your bottom. But again, that type of intermittent fasting and a longer fasting period induces that type of metabolism which is good for getting rid of fat.

RON AARON
For a longer fasting period, meaning more than 12 hours a day?

DR. RAJAY SEUDATH
Typically, it's a 16-hour fasting amount. For most of these that I looked up, an eight-hour eating window, and then 16 hours where you're not eating.

RON AARON
Which includes your sleep.

DR. RAJAY SEUDATH
Yes. That's correct. If you're asleep, early to bed, early to rise, it makes a man healthy, wealthy and not starving.

RON AARON
For those who are listening to this who are interested in this, how do you begin? What would be the way to kick it off? It's almost like, how do you get off the couch and start exercising? How do you start intermittent fasting?

DR. RAJAY SEUDATH
The first thing that you could do if you are serious, talk to your doctor. Talk to your nurse practitioner. Talk to your primary care physician, your primary care provider that I want to make a change for my health. That person is uniquely poised to guide you. Like we said, do you just jump right into intermittent fasting? Well, it may not be for everyone depending on your diseases. So, talk to that person. The second thing is make sure that we are doing the things that will allow you to succeed. We talked about self-accountability, writing down what you're eating, maybe even keeping it on your schedule or on your calendar, or keeping it on your phone. Maybe you have an alarm that goes off that says, I can't eat after this time. Or the bell rings and okay, come and get it. You might get this kind of pavlov type of response where you hear that alarm where it's time to eat, and all of a sudden you're salivating. You're ready to go. That would be some of the things that is that type of self-accountability. I would say working towards portion control and working towards your meal planning. One of the things I saw was people who spend more time eating for the sake of eating and not watching TV while they're eating, not reading while they're eating, they're focusing on the taste and the texture of the foods that they're eating and consuming actually helps with satiation. So, putting more time in that eight hour window where you're actually eating. If you eat everything at five minutes, your body doesn't have the chance to become satisfied. So, extending that. All of those things together can really make a person successful for intermittent fasting. So, I'd say first, like I said, talk to your provider. Two, make some plans. Three, plan your meals. Four, keep the accountability. Stay on the wagon.

RON AARON
Well, you have carried us to the end of our discussion. I really appreciate it. This was very, very interesting. If you want more, obviously, you can Google it, or best of all, talk to your primary care physician. Dr. Seudath, as always, it is great talking with you. I've learned a lot, and it's something that perhaps I will try intermittent fasting.

DR. RAJAY SEUDATH
Absolutely. Thank you so much for having me.

RON AARON
Thank you very much, Dr. Seudath. I'm Ron Aaron. I thank you so much for joining us today on the award winning Docs in a Pod.

OUTRO
Executive producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. Be sure and listen next week to Docs in a Pod presented by WellMed.

DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.

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