Pam Peeke, MD: Hi, I am Dr. Pam Peak, and This is episode number 548 of the Bold And the Brave. Her podcast. today I'm joined by a repeat offender. That's right, Dr. Susan Kleiner is back again. Absolutely. There she is with her little heart and everything and she is absolutely extraordinary. The owner and founder of High Performance Nutrition, uh, with PhD in an RD and every single kind of education and academic standing you can in the nutrition world.

Um, and she has written countless books, And the latest one was The Good Mood Diet, feel Great while you drop that weight. Oh no. That wasn't meant to really rhyme, was it? It was. Okay. I get it. I get it. Anyway, so Dr. Susan Kleiner, welcome back to the Herb Podcast.

Susan M. Kleiner, PhD: you so much Dr. Pam. I am thrilled to have, be a returning guest or a repeat offender, however.

Pam Peeke, MD: I kind of like repeat offender. I don't know, maybe I have like some law enforcement in my blood somewhere.

Susan M. Kleiner, PhD: I think it's just the rebellion in you.

Pam Peeke, MD: You know something, you are absolutely correct. You know, you always nail it, Sue. I'm just saying. So here's the deal. Here we are at the beginning of a new year. 2026 and you know what's on everyone's damn mind. And That is, their number one thing is health. and usually health is translated into weight.

because, the majority of Americans, I'm only gonna stick with Americans right now, the majority of Americans, are at least overweight. Okay. At least overweight. And they've been that way. since 1996. Quite frankly. We've had a majority of people, of course, overweight then was like five or 10 pounds. Now it's more like 30.

And then we have, and women are worse than men. a greater percentage of obesity out there in women. Gotta say we're in the forties, right? 40%. So we've got all kinds of things going on. And then we also have the GLP type medications floating around. the, announcement about Wago v.

from Novo Nordisk, coming out in tablet form now, and basically oral form just hit the news. And so now we've suddenly got all kinds of interesting options out there. and people are sitting there saying, okay, what am I supposed to do? And. Talk to me about this whole issue of intermittent fasting since it's everywhere and people are talking about it all the time, and what's going to end up working well for people.

that's a huge mouthful of wild and crazy stuff. But what I'm saying quite frankly, is that the world has become more complex. Okay? Now I'm gonna ask you, Sue, right? in the years past. Don't people write about this time of year? Say, uh, I gotta do a diet. Okay, so what's your thought now?

Susan M. Kleiner, PhD: Well, now hopefully it's at least diet and exercise and maybe we have, we, we've had an impact. I know my gym is packed right now, and I love to see that. Although, I have to say in the weight room, I still am one of very few women, and girls that.

spend time in there, although I have to say all those young dudes no longer ask me if I'm actually using the rack, if I'm standing by it with weights on the bar, it means I'm really using that racks.

Pam Peeke, MD: I love that, that's such a great anecdote. I just, you know, are you really using that? No, I'm just standing here like a moron staring at the wall. What do you think I'm doing? You know, if you were standing here, what do you. I, I wouldn't even ask you.

Obviously you're using the rack.

Susan M. Kleiner, PhD: know. So, but I mean, I am, I'm always looking at the bright side And so I, along with the idea of diet, food restriction and weight loss, I think that the exercise message is beginning to hit home for more people. And I think that the concept of weight loss.

Is beginning to overlap, at least with health and fitness and lifespan and health span, meaning that you can enhance the quality of your life over the years that you have by eating well and exercising. However, there is no doubt that when we start out the year. If you pick up a magazine, if you open your laptop, if you look on your phone, if you're scrolling in social media, what you're going to see are as many weight loss plans as there are, I think, stars in the sky.

So how do we know number one. How should we eat to be healthy and promote a lifestyle that we want and support our exercise that we wanna do? And the other is this alphabet soup of drugs available to us now to help control how much we eat. Not what we eat necessarily, but how much we eat and how hungry we are.

All of This is kind of converging at this time of year to the concept, as you said, of either, we think of it as intermittent fasting or time-limited. Time-restricted eating. You'll see both terms. You'll see if f and TRE, we just love this alphabet soup, but it's the same thing.

Time restricted eating, intermittent fasting, and it overlaps really with the GLP one drugs. And so how do we, find our way through the forest?

Pam Peeke, MD: Oh, I'm gonna put something out there for you. Sue. I really want to hear what you have to say about this. Okay. So This is Dr. Peak's take on the whole damn thing. Let's just cut right to the quick. Okay. We're not gonna sit here and do, like now, now we're gonna talk about 16 hours of fa No, I'm gonna tell you One of the things I found after I met an extraordinary scientist, Dr. Sachin Panda at the Salk Institute, who became a good friend, was the whole issue of honoring.

The clock. Okay, so I'm all about circadian rhythm. In other words, let's just go back to cave woman days. And I gotta say, I've always used this analogy and I just had on the show. Dr. Marian Nessel, one of the greatest names in, nutrition science. She and I are both, Berkeley grads she's a trip and a half, and of course she just published her new book, what to Eat Now, which

Susan M. Kleiner, PhD: like this.

Pam Peeke, MD: Yeah. I, it actually weighs more than I do. I use it as a door stop. No, it took her four years and she thought it was gonna take six months to update her original book What to Eat, and she found out that all the food that she had discussed in the original book doesn't exist anymore.

You know, that's how fast everything churns through all these fads and whatever. So here's my take on it. and interestingly, she said the Same thing. So I feel somewhat affirmed. Okay, so here it goes. We look at ourselves as caved women. Let's just be a cave woman for a moment.

All right. What time did you wake up? when some light hit the cave And then you heard the Tweety birds, And then you said, man, I'm hungry. And guess what? There was no seven 11. There's no Kroger grocery. Come on out. No

Susan M. Kleiner, PhD: refrigerator.

Pam Peeke, MD: Like, girl, your your ass is up and moving because if you don't move and groove, there is no food. Right? And so you get up and suddenly you are physically active. No gym needed, man. You gotta survive. And so you're up with the Tweety birds part of This is survival.

You don't wanna be in there when bad things wanna crawl in there and, You know, have you for lunch. So out you go with your little, You know, tribe or. Whatever the hell. and, you know, you're, you're foraging and messing around and you know, you pick up what you can.

Oh look, there's a, a raspberry bush. let's grab some of that stuff. Instead of saying like, oh, I can't have that. It's got carbs in it. I mean, I just wanna laugh my ass off. Every time I think about how ludicrous it is. It is, it is like, oh my God, it is.

It's some carbs and yeah, it's called Living in Survival. And now eat the, eat the whole bush if you have to. Come on now. And then of course you know if you're lucky, lucky you get one main meal. That day. Otherwise what you have is a bunch of stuff you could just pick and poke and, hope that, you know, you can pretty much survive until the next day when hopefully hunting is more productive.

And so you're running around physically active. Just by virtue of survival. and you're eating a little here, eating a little there with regard to physical activity. You're resting here, you're resting there, so it's this beautiful harmony of a little here or a little there all intersperse throughout the day, and there are definite times when you have nothing to eat when you're fasting.

I mean, it could be that it's snowing out or, you know, whatever the issue may be. and our bodies were meant to utilize fasting, to our metabolic benefit. And we see this in all of the research that's poured out over this whole issue. So, I look at the cave woman.

You know, kind of ethic. And I say, you know, women say, yeah, but today is 2026. And I'm like, I don't wanna break your heart. You know, really, I, I am the messenger, so don't hurt me here. But to affect enough metabolic change in your genome. To thoroughly adapt to the insanity of what we do to our bodies today is impossible.

'cause it takes a long time for the genome to really show, You know, substantial change. The epigenome obviously does, but the genome itself. So, for all intent and purposes I see myself as that cave woman. Dammit. So I'm up with Tweety Birds and I know, I know there are night owls out there.

We'll get to you. by the way, if you are a night owl, you are the one guarding the cave. You were the one to raise your hand saying, oh, I got this. You know, like I'm a night owl. but for the rest of them, You know, the mass majority like to, You know, do the morning thing and you just follow it like that.

And what time do you think they stopped eating? When do you think they stopped eating? Yeah, it's like they either never had anything to eat in the first place. in which case, You know, they went directly into some level of a fasting state or they actually had something to eat, you know, that was fairly substantial.

And then, you know, as soon as it became sunset, it's like, my ass is outta here because. All kinds of things crawl out of the forest in the dark and they want me for dinner. And so you go back to a safe place And what do you do there?

Well, you like, You know, crank out your iPad and your iPhone and you start doing a little texting. Come on now. No, it was dark in there and plus you didn't wanna have a whole lot of anything going on 'cause you don't wanna attract. Any of the bad boys.

And so you went to bed in an appropriate time. You went to sleep and up you went with the Tweety birds. Basically rinse and repeat. Okay. That's the way it was supposed to work. let's look at it now. Sue. What does it look like today? What's your classic kind of situation today?

Flash forward.

Susan M. Kleiner, PhD: Well. Six situation today is, you know, it's fascinating, when you've been in a field for a long enough time that you see the arc of change and sort of the histotripsy points when, things impact our behaviors. So in nutrition and particularly Marian Nessel, Has seen the impact of the food industry on our eating behaviors.

So, It used to be that we ate three squares a day, let's just say that, and that's been going on a long time, right? We've eaten three square meals a day, breakfast, lunch, and dinner. And sometime during the 1980s that I remember, 'cause I was already a registered dietician in the field of sports nutrition, we started to talk about snacking And that athletes needed more fuel and they needed to prefu before exercise.

And this was all. Focused in sports and very active people. Well, the snack food industry, which was taken over by the cigarette industry who were masters of altering habits and behavior and influenced the way people thought about things. They saw this as an incredible opportunity. Also, as they started to develop all of these.

Ultraprocessed food technologies, and it was this opportunity to say, wow, if Americans start snacking, we can feed them and sell them a ton more food. And so all of a sudden, what was to me, sports nutrition advice became advice to the average person. In concert with, I have to be honest.

I'm going to call 'em out. Gatorade. When I started working in the early eighties and mid eighties with Gatorade, Gatorade was a sports drink. You drank it to fuel your exercise at a point. Late eighties, early nineties, they changed their marketing to what they called a beverage of choice all day long, which is when I stopped working with them because I didn't understand why kids in school should be drinking Gatorade all day long.

Why anybody should be drinking Gatorade all day long. And it was all happening at the same time. Everybody needs to eat small, frequent meals all day long. And then it became three big meals with three snacks a day, And we were just buying the heck out of all these products, and there was never any.

Substantiation that that was better for us. At the same time were, we were being told that, you know, fats were bad for us because we had the Framingham study that started to tell us there was a problem with fat in our diets and leading to heart disease. And so now we had all these new processed foods that were high in carbs.

Processed carbs, low in fats. You could eat those all day long. And here we are. We are eating all day long. All kind of things that may or may not give us good nutrition. and certainly way more calories than we need to be eating because we never need and process.

Right. And so your story about how people ate at the beginning of human history. It is certainly relevant because, except for maybe a minor few flips of a genome, we are in the same bodies. Right. as you said, we have not changed in the last, what, 10,000 years.

Pam Peeke, MD: Sue, I identify as. A

Susan M. Kleiner, PhD: Yeah. There we go.

Pam Peeke, MD: I do. I identify as a

Susan M. Kleiner, PhD: but but you would be a miracle cave woman, right? Because. Women didn't live much past their childbearing years. And so the new story is because when you're young, you can do almost anything and survive until you get a cut and there's no penicillin and you die of an infection.

But when you age. We also have some other things happening that may not have been happening during 10,000 years ago, but that we are understanding through research does help and. One of those things is not having our digestive systems so full all the time that the rest of the body doesn't get the blood flow.

It needs to recover on a daily basis.

Pam Peeke, MD: Nor does it have an opportunity to clean up its mess, which is where fasting comes in. And that fasting piece, you know, people just need to understand. What that's all about. And I honestly think the work of both, Satchin Panda at the Salk Institute, as well as Dr. Volter Longo, at uscs, their large, longevity and, geriatric, institute, has really helped us understand why it is.

Extremely important and beneficial to allow the body time to, as it were, rest and digest, which is what the parasympathetic nervous system does, rest and digest. Instead, what we do is we eat. 24 7, I swear it's insane. there's no time for the body to clean up, the breakdown products, of both physical activity as well as, you know, what we eat.

and therefore the non feeding time, you know, we call it fasting, but the non feeding time is exquisitely important. there was a fantastic Japanese, scientist who won the Nobel Prize, in identifying autophagy. Um, And that. Fancy word basically means how shall I say this? you're gonna love my analogy.

So it's like a Dyson goes right through all your cells and sucks up all of the debris, the dying cells, the pieces of cells hanging out, toxins and whatever else. During the phase of autophagy, when you've, you've had at least six hours for sure, of not eating, And then you enter, a stage of autophagy, then it's important.

To honor that time where your little dyson's running around, cleaning up the mess, And then you have cellular rejuvenation and regrowth, And the cells aren't having to deal with all of this extra debris and whatever. That was the magic behind, You know, the whole issue of the fasting or non feeding hours.

Now the question is, what does that actually look like? You know, if you pull up all kinds of articles about intermittent fasting or whatever, you know, you'll see everything from people who will once a week just drink water. for once a week. Other people are like, okay, well, what I'll do is I'll cut my calories like in half, every other day.

And I'll do that. So I'll, I'll kind of, as it were, suffer every other day. And that's alternate day, fasting. And then you have all kinds of nuances with regard to how many hours per day you actually fast versus eat. So, between you and me. In talking to some of the world's experts, who I met at Vaulter's, you know, big fasting conference a number of years ago.

they came in from everywhere, Europe, Australia, uk, all the rest of it, and they all said the same thing. The sweet spot was eating during a window of 10 hours. And having 14 hours to be able to, get that little, vacuum going in your body and cleaning things up.

That's what that's all about. and it really isn't a vacuum, per se. What I'm being facetious, autophagy actually means. You are eating yourself, meaning that your cells, the old debris is being cleaned out, by systems, throughout your body, that are refreshing your cells. So I think I'm arguing now for the ability to be able to find a way.

That everyone out there in the Herb podcast land can, individualize and customize and experiment with, being a little bit more, how shall we say, cave woman ish. in which case you have to find out based upon your crazy life and all the things that get in the way and back and forth.

What works best for you? When I was talking to Dr. Nessel, she said, you know what, everybody says A way to eat is successful if you can sustain it over time and it has healthful benefits. if you can't check those two boxes, whatever you're doing is crazy.

Susan M. Kleiner, PhD: Yeah. So, yeah, absolutely. I mean, it's always, you know, speaking as a nutrition coach, if you can't do it, it doesn't matter. I could create the best, healthiest diet in the world. If people don't eat it, it's irrelevant. And so, ideally, we can. Hang our hat on a few data points, but it doesn't mean that if you can't, if this doesn't work for you, then.

Drop the whole thing. So as you said, eating in the morning versus if you set your 10 hours, let's say starting at six or seven in the morning or eight in the morning, whatever time in the morning, you have something that resembles a breakfast in your mind, eating earlier, And then going into your fasting.

Sort of by seven or eight o'clock at night. not eating late at night, rather than saying, I'm gonna eat for 10 hours and I'm gonna start at noon and I will eat till 10 o'clock at night. Well, the data are showing us that it's actually more healthful. And if you're trying to lose fat, It is slightly.

Better to eat in the morning versus eating late at night. So that's

Pam Peeke, MD: Well, there's another reason for that. Piling on that we know that, um, throughout our body have a circadian rhythm. One of them, is insulin. And so insulin tends to be most efficient in the morning up until about early afternoon-ish. So if you're eating a boatload of food, you know, like say Mount St. Pasta for dinner, Then you are flooding your body with a boatload of carbohydrate that your insulin can't manage optimally, And that will be stored as fat guaranteed.

So the rule is if you really wanna have some great carbohydrate, that usually involves like a starch, then to do it in the morning, or at, I love to call. The meal, that takes place around one-ish, you know, two-ish. the main meal of the day, that's the main meal.

'cause all of your hormonal systems are operating optimally and you'll be able to metabolize much better than if you were, you know, chowing down at nine o'clock at night or eight o'clock at night even. So you gotta be so careful. That's why I keep saying that clock. Circadian rhythm.

You know, we, we could talk all day long about fancy programs you and I can create and they can sound real sexy And we could TikTok them out and whatever. But I don't want, again, I don't wanna break anyone's heart out there. Here we go. Okay. You have a prehistoric circadian rhythm built into every cell of your body.

Every cell has its own clock, and you know you can wish and hope all you want, you could pray over your body. It ain't gonna change you. You're gonna have a circadian rhythm that honors the rotation of the earth. Right, because that's happening on a circadian rhythm. Last time I looked it was called sunrise and sunset.

And you can't mess with that. I know. You're trying to mess with that. You go put, I got lights on at nighttime. Yeah. Well thanks for sharing, but you know, your body is still working on a Arcadian rhythm, you know, and you gotta, stay with it. And that's why I argue, against anything strange.

That really deviates from that too much. You know what I mean? You could still customize.

Susan M. Kleiner, PhD: And that 10 hour window, I like that, um, even better than the eight hour window and 16 hour fast. Is because as women typically we can't get in all the nutrition that we really need in a brief period of time. I mean, some people do four hour eating windows.

It's just not long enough for us to eat well and get in all our nutrition. And so the eight hour window. eight to 10 hours, let's say, is much more practical for most of us and allows you to live a social life, allows you to go out to dinner with people.

Just say, I need an early bird dinner, but, but.

Pam Peeke, MD: Oh no, not the blue plate special. Hey, listen, when we come back, Sue, I'm gonna be talking more about this whole issue of how do we make this practical. You and I as fellow cave women, I. And

we're back. Okay. Hey, cave woman. So here's the gig, We wanna make this work so that women, you just said it, women can see the practicality here And the fact that it will help you. Because when women say, well, I'll go to the gym and I'll just work it all off, look.

Don't wanna break your heart. That's not the way this goes. The science shows that if you really wanna peel off some extra fat, the best way to do it is through nutrition. And then physical activity adds the period at the end of the sentence, So, It makes it sustainable, and it maintains that beautiful metabolism.

But nutrition is absolutely queen here, isn't it?

Susan M. Kleiner, PhD: Yes, yes. Although if you are focusing only on nutrition for weight loss and restricting your calories, you're also losing more muscle than if you would be working out in the gym. You'll hang on to more muscle, while you lose weight because we really don't care what you weigh. I mean, what you weigh only represents the relationship of your body to gravity.

What we care about is the proportion of fat to muscle. And so, we're always gonna lose muscle when we're losing weight. we hope to lose more fat and less muscle. When we're gaining weight. We're gaining, hopefully, if we're working out, we're gaining more muscle and less fat, but it's always a ratio.

And so in this case, we want to focus on our diet, on our nutrition, on the food that gives us. All of the nutrition to build our bodies up so we don't tear them down. The point is, as we live through each day, each week, each month, each year, that we get stronger, that we are more capable, not less.

And so that requires. Really good solid nutrition. And so over that, let's say 10 hours or eight hours, you still need all that protein that we've talked about and it's been talked about multiple times on this podcast. and you don't wanna get in, you know, 90 grams of protein in one slug.

That's disgusting. It's also not good for your intestines and your digestive. Right. And so when we, we want to separate, we still wanna separate out our food, we still wanna fuel our exercise. We don't want to under fuel training. You can under fuel later in the day, but not before your exercise.

'cause then you don't get the biggest bang for your buck when you go in. To train, And so making sure you're well fueled, getting in your protein, getting in all the fiber that we need so that you still have that, low inflammatory response in your gut, which transfers out to the whole body.

To get in the bone building minerals. I mean, I could go on and on. So the story is the same whether you are on a calorie restricted diet or a time restricted eating pattern, you still need the basic foundational nutrition to be super healthy and to train well, and to keep your mind clear and do all the things that you wanna do.

Pam Peeke, MD: Actually magic about, your natural circadian rhythm is. effortlessly, I mean, effortlessly, you end up eating fewer calories because you have less time to munch out. I mean, if you're eating well, actually, when Satchin Panda began his, his scientific work, he went ahead and he just found out what a baseline number of hours of eating, of the average American, and he found out that people eat on average.

15 to 16 hours a day. I mean, it's like a second career. Excuse me. Hi. I'm a software engineer and I'm also someone who eats, um, you know, it's like your second career. So, you know, when he saw that, he was like, uh, Roro that, that's leaving No time for that.

cellular clean. The autophagy, people are eating later, they tend to move it down and they tend to, you know, pack in the largest chunk of calories, usually processed in very heavy stuff by volume. in the evening, which is again, the worst time to do all that. That's like a guaranteed, a way to be able to pack on pounds.

Susan M. Kleiner, PhD: You know, on your way to marginal diabetes.

Pam Peeke, MD: I, I know it's like pretty nuts. So This is where he just said, okay, let's all calm down here. Now, you know, all together now, and This is the way it's gonna look. What we're gonna do is we're going to come up with a reasonable window. Now, by the way, the only reason why he used in his experiments, which he did, in the beginning with, animals.

these are rats and, mice. And then he eventually went to humans. He used 16 eight because it was the easiest thing. And also, as you know, and I know as researchers, whenever you do research, you, you wanna get your biggest bang for your buck. You go for a bit of a harder protocol where, you know, for a natural fact you're gonna get a really cool result.

You know what I'm saying? And so, I think that.

Susan M. Kleiner, PhD: Kind of the deck.

Pam Peeke, MD: well, the other reason why you're gonna love this, when Sachin told me I fell off my chair, I was laughing so hard. He said in my original experiments, which were all published in Cell, which is one of the top, mags, journals out there for us. Um. his head research, guy running, you know, managing the protocol and everything.

For him, he needed to be home by a certain time. Okay. I'm not kidding. I, I wish I could make this up. No. And he said, You know, I can do the 16 eight thing 'cause it works well with, You know, my household and how everything's wor, but I can't do this other, you know, And we can't do, You know, 14, 10 and whatever.

He says, I gotta get these rats eating over eight hours And then You know, we're dead And then let's move along. So I laughed. and that's just another perfect example of how crazy science can be when you're executing these experiments. So. I personally, ever since I met Satchin, I'm not kidding you, I literally changed on a dime.

I went out to the Salk Institute. I was out in the West coast for other meetings and I just, popped on by to see Satchin And we spent hours. the science was so compelling that I switched over everything for myself. I have never felt better in my life. So, you know, plenty of wiggle room.

Now here's where, where it gets cool, do you think you have to live like this every single freaking day? Of course not. there's wiggle room. So some days I may do 12, 12. Which is what a lot of people do. You know, 7:00 AM to 7:00 PM we're all good.

Whatever. Okay. Sometimes I'll do, 10 and 14 some days just turn out to be wild and crazy and I end up with a 16 eight just 'cause life happens that way Now. He did more experiments you know, very, very well. And what he did was over the weekend he decided to just sort of mimic what Americans do, which is let it rip.

Okay? So he, he allowed the. mice or rats to eat whatever in the hell they want. Now, they were no longer restricted to the 16 eight and whatever, and they ate whatever they wanted. I mean, they had food available 24 7 and sure to form, you know, they definitely took 'em up on that.

But here's what's weird. When they looked at the metabolism, all of the metrics, everything from blood glucose to insulin levels and all the rest of it. When they actually looked at their metrics, the animals who had been Monday through Friday, pretty much on the money, right? And then let it rip on the weekend.

It didn't even matter with their weight, body composition or with any of their, labs. And he was astounded, astounded. then he began to put two and two together. And here's something that you're gonna love when you do this little honoring the the clock thing. What happens is guess which Fat Depot is the most sensitive to weight loss?

Visceral fat. That's the Mac daddy. That's the one you need to really control because when you have too much intraabdominal fat, too much of it, obviously you have some, it's normal, but too much of it, man. You got diabetes, like you said, cardiovascular disease. Cancer's up, You know, it's a bad situation.

So I love the fact that your body forgives you for your little, nuances on the weekend. so long as you're right back at it on Monday. And most people have found after they've been at this for a while. They tend not to deviate too much anymore. It's sort of, have you noticed that in, in, in working with people?

Susan M. Kleiner, PhD: Yeah, so this concept of the 80 20 rule has been around forever, right?

Pam Peeke, MD: Oh no, not the 80 20 rule. Oh, no.

Susan M. Kleiner, PhD: that's kind of what you're talking about, that 80% of the time you're on task and 20% you get to, you know, deviate. And so, the body. Likes to, I don't wanna say go in a straight line, but it likes to stay within certain parameters And so you train it, and when you train it.

Even within whatever intermittent fasting or time-restricted eating, whatever, even calorie restriction, when you set it on a path, it likes to stay on that path. Even if you do a little deviation, you drive, you know, off the road. If you completely go in the ditch it, you know, all

Pam Peeke, MD: we've been there. Trust me.

Susan M. Kleiner, PhD: You go on a vendor and it's, it's over. But if you kind of, it's teleological or we're giving, description to body cells as if they have a brain, which we actually know, they kind of do. It's amazing a whole nother research area. But When we, let the body understand what the expectation should be, it stays on track And so that we can deviate like this.

That's why all these different patterns, two days of fasting, five days of eating, or three days of alternate. Sort of, kind of sort of fasting and four days of eating more on time restriction or whatever. You do those things. the body will adapt. I think in my experience of working with many, many, many people, the sort of regularity of every day works best And the two and five often.

You know, people start out that way and they fall off the wagon. It becomes difficult, first of all, to truly fast all day and still be functional. I mean, unless you're someone who has no other responsibilities. To show up for anything. Fasting all day is uncomfortable and you don't, perform at your best, And so that's why this time restricted eating.

is so beneficial. It puts us in the sweet spot during the hours that we need to be sharp and alert And we can feel well fueled to go to exercise, And then it lets us. You know, rest our body and recover in the alternate hours. And that's why I really, I like that pattern.

But as you are saying, everyone should find what works for them and know that This is not mandatory. You can also, if just eating less without time restriction works well for you, then do that.

Pam Peeke, MD: I mean, you know, it, it, you have to experiment And also you. Know, let's talk about women, you know, women's needs their nutritional needs. They'll change over time. so I've gotta tell you the little anecdote with, Dr. Nessel. it was a really great, interview 'cause she's always been one of my, kind of icons in nutrition and she turned out to be a riot.

She's 89 years old.

Susan M. Kleiner, PhD: you know, writing books and emer

Pam Peeke, MD: Yeah. And she, well, she's got her faculty office and You know, and you're like, I wanna be like her. toward the end of the interview, we were just hanging out and I said, so like, how do you eat during the day? Like, You know, you're one of the queens of nutrition, people buy all your books and you know, we hail you as the one.

She goes, oh, okay. Well let's see now. Yeah, I wake up in the morning and I don't like breakfast, so I'm like, okay, alright. You don't like breakfast? She goes, yeah. I don't really start feeling like I wanna have anything until about 11, and I'm thinking about all the RDS out there falling off their chairs, going, what?

but, hey, I don't wanna, you know, again, Break your heart in 5,000 pieces, but she's 89 and you are not. And that means that she knows something that You know, and she's awfully healthy right now. And so why don't you listen on up. So what's the lesson here? And her telling me that, well, you know, let me finish the rest of the day.

So I said, oh, so what do you have? She goes, you know, probably some cereal. I said, really? What kind? And she goes, oh, multi-grain. I like that. And might do some multi-grain stuff and every, everyone's falling off their chairs, gluten and all those horrible things that are ripping your microbiome into shreds.

And meanwhile she's like, eh, it's worked for years, you know? And then I said, well, what do you have the rest of the day? I dunno. You know, it's like whatever's around and, you know, I just sort of put it together. And then, I said, well, when do you finish eating?

And she says, You know, I eat early. notice I said that, and I eat early, you know, like I'm, I'm finished up. I no later than, you know, 6, 6 30 and I'm good to go. Right? so. What did we learn from all of this? We learned that, there's a lot more wiggle room than you think, number one.

Number two, being super rigid and strict and, you know, having to grind your teeth through it. Is not helping you. last time I looked, I don't know, food's supposed to be delicious and n nourishing and nutritious and enjoyable, You know, all those neat things. So what happened to that?

And, I think that also what's all over TikTok and, you know, Instagram and God knows what else. YouTube are a bunch of young men especially who are on very rigid kind of stuff that, you know, they give it all kinds of and whatever. And then they've got, you know, kind of tech bro bodies, they're lifting weights, doing their thing.

Susan M. Kleiner, PhD: They're shooting into themselves

Pam Peeke, MD: Yeah, well, I'm not gonna even go there. Um, And so, I think it really influences a lot of people. Now let's quickly pivot to something that you and I were talking about before the show. What is going on with women? Now we're talking about health, And we know that if you live a little bit more like a cave woman, you know, with nuances around that, your numbers, your lab numbers improve beautifully.

Your visceral fat and your belly fat improves, tremendously. We have tons of evidence that shows that your waist. Circumference decreases, and of course if you're having enough protein and lifting weights, your muscle mass will be optimized as well, but. Oh my God. So, you flip through the pages of Vogue Magazine and we're back to the skinny women again.

you know, I saw one the other day that had about 14 feet between her thighs. she has like, what, where did you come from? stick land. yet for a while there things had changed. What happened there, Sue?

Susan M. Kleiner, PhD: I think it's the fashion industry, honestly. I mean, they need us to buy new stuff. Year in and year out. And if they change the body type, then the fashion itself changes. And so between Hollywood and the fashion industry, and of course social media. We are seeing a return to the bad old days of the 1980s.

Before that, I remember Twiggy, which was the same kind of image, but we didn't quite understand. I think what we were looking at at that time. That was the 1960s. And so, by the 1980s, sort of the anorexic body type became very popular And the whole. Concept of, a muscular woman or a well-defined body for a woman just was not in vogue.

It was neither in vogue, nor was it in Vogue. And so we went through such hard work to change that image, to educate a whole new generation of women to be comfortable in their skin. That who you are does not is not defined by the way your body looks That.

Health is what matters. Taking care of your nutrition, your mental health, your physical wellbeing, all of these things are good for, as we talked about, health span longevity and to be strong contributors to the world around us. And now it is going back. It is, we are seeing, skyrocketing levels of cigarette smoking in the younger generation,

Pam Peeke, MD: And for a long time they had given that up too. Well, there's another layer to all this And the other layer, it's very interesting once these, weight loss, drugs. Popped up. Now all of a sudden, there was the most fascinating op-ed in the Wall Street Journal written by a psychiatrist whose name is Alfred May. He might be a psychologist, psychiatrist, one of, I think he's a psychiatrist.

What he basically said was patient's were coming in saying that they had bought into the body positivity thing. when they say they bought into it, they did that. Publicly, but secretly to themselves, they never bought it. They were never happy with their bodies. And now that they're on GLP and their bodies are changing in a way That is more beneficial in terms of their health and wellbeing, their numbers, the labs And the rest of it, they're almost afraid to say anything because there's been this.

Kind of an ethos out there of it is okay if you're, substantially obese. And when according to Dr. Alfred, he said that, no, that's not true. That's not really true at all. That most people really wanted to change for the better. They just had no tools to do it.

And now you have these meds and suddenly the body positivity movement, per se, has morphed. Now I'm gonna make very clear to everyone what I mean by this. Every woman comes in a magnificently awesome shape and size. You need to love yourself. you need to be able to be proud of who you are, mentally, physically, spiritually.

You need that. That is absolutely foundational. But you also have to pay attention to your health. And so health is exquisitely foundational. You believe whatever you want, but if you have no health. Then you got a problem. And now you know, if you look at all the new NASH global trends, the global trends are health, wellness, and longevity.

So. If you're doing everything you can to be as healthy as you can. How about that meditation? How about taking, you know, those walks? How about connecting with other people? How about eating nutritious whole foods and doing something radical called cooking? how about, addressing your sleep and your stress, all those things.

That's what I'm talking about. And then your body will follow. Don't start with the body. The body is going to follow when the process of how you live changes for the better and all along. You still love yourself, you're proud of yourself. It's just that you've got to remember to weave in health and wellness throughout.

Susan M. Kleiner, PhD: Oh, absolutely. So the GLP one drug. Are an amazing advancement. Undeniably people struggling to find health who couldn't do it on their own, just eat less and exercise more. Right? Just like we say, just say no to drugs. Those things, platitudes are not helpful. And so the GLP one drugs I think are in an early phase, but they are.

Helpful for the proper individuals. But even within that, as you're saying, even when you have the medical support or the pharmaceutical support, you still need to understand how to adjust your lifestyle so that whether or not you stay on those drugs forever. You are supporting health, And so I talk about weight loss is not a goal.

Weight loss is an outcome of changing all the things that you have talked about and giving yourself a pat on the back each day. For going out for a walk, that's your goal. Being a little more physical, active, getting up off the couch, doing something and planning and carrying that through on a daily basis.

Setting up a time when you have a creative, expression during your day, having your spiritual, opportunities, making sure that you have strong relationships in your life. Doing. You know, making the world a better place through volunteer work or whatever that may be, and eating well and hydrating well, each one of those on a daily basis or a weekly basis, Those are goals that

Pam Peeke, MD: And that's exactly how we're going to end this, this fantastic episode with you. What a beautiful way to be able to summarize all that. Remembering, that both of us said the same thing and you said it so gloriously, and That is any level of excess fat in your body That is reduced.

It was never the goal, it's an outcome because the real goal was to clean up all of those other elements to start with, And so I think that That is a powerful message coming from Dr. Susan Kleiner learned more about her incredible work at her website, Dr. Kleiner, and That is DRS.

K-L-E-I-N-E r.com because she's so damn smart. And This is why, you know, we keep grabbing you again and again to help elucidate some of these crazy controversies and, issues that women really wanna get to the bottom of. And we did that today with our little cave woman, episode here.

so again. Thank you, Sue, for being on the Herb Podcast.

Susan M. Kleiner, PhD: My. Or Thank you, Dr. Pam.

Pam Peeke, MD: And I wanna thank my sponsors, SORAY Vitamins, minerals and Herbs, rooted in nature And the new her Life stages. Products that help a woman, oh, they've got her back from menstruation all the way through. Post menopause. Scope it all out at soray, S-O-L-A-R-A y.com. And now take a moment to leave us a review.

'cause um, we just sit around waiting to hear from you. this has been a production. Of podcast health and you know, yeah, yeah. Your time is limited in this world, but the things you can do at that time are certainly not. So you choose to get up off your feminine behind and get out there and seize the day.

Carp a DM girlfriends. Thanks for listening.