1 00:00:05,520 --> 00:00:10,080 >> GOOD MORNING. 2 00:00:10,080 --> 00:00:14,920 I'M DR. SHILPY DIXIT WITH THE 3 00:00:14,920 --> 00:00:16,440 NATIONAL HEART, LUNG AND BLOOD 4 00:00:16,440 --> 00:00:18,360 INSTITUTE AT THE NIH. 5 00:00:18,360 --> 00:00:20,880 ON BEHALF OF THE NHLBI OBESITY 6 00:00:20,880 --> 00:00:23,160 WORKING GROUP I'M EXCITED TO 7 00:00:23,160 --> 00:00:25,720 SERVE AS MODERATOR FOR THE 8 00:00:25,720 --> 00:00:27,880 12th OBESITY, NUTRITION AND 9 00:00:27,880 --> 00:00:29,360 PHYSICAL ACTIVITY SEMINAR. 10 00:00:29,360 --> 00:00:30,400 PAST PRESENTATIONS HIGHLIGHTED A 11 00:00:30,400 --> 00:00:33,800 VARIETY OF TOPICS SUCH AS 12 00:00:33,800 --> 00:00:35,440 TECHNOLOGY ASSISTED INTERVENTION 13 00:00:35,440 --> 00:00:36,840 FOR WEIGHT MANAGEMENT, FOOD 14 00:00:36,840 --> 00:00:40,680 INSECURITY AND COVID-19, ROLE OF 15 00:00:40,680 --> 00:00:42,880 TEACHING KITCHENS IN ADDRESSING 16 00:00:42,880 --> 00:00:46,360 NUTRITION DISPARITIES, AND MANY 17 00:00:46,360 --> 00:00:48,120 OTHERS. 18 00:00:48,120 --> 00:00:49,560 TODAY'S PRESENTATION IS ENTITLED 19 00:00:49,560 --> 00:00:50,360 INTERMITTENT FASTING AND 20 00:00:50,360 --> 00:00:52,080 CIRCADIAN CLOCK, DOES WHEN YOU 21 00:00:52,080 --> 00:00:53,760 EAT AFFECT YOUR HEALTH? 22 00:00:53,760 --> 00:00:55,240 BEFORE WE START, I WANT TO 23 00:00:55,240 --> 00:00:57,920 REVIEW A FEW HOUSEKEEPING ITEMS. 24 00:00:57,920 --> 00:00:59,160 THROUGHOUT THE PRESENTATION AND 25 00:00:59,160 --> 00:01:02,480 DURING THE MODERATED Q&A, PLEASE 26 00:01:02,480 --> 00:01:04,920 SEND ANY QUESTIONS TO THE E-MAIL 27 00:01:04,920 --> 00:01:12,440 ADDRESS LISTED ON THE SLIDES, 28 00:01:12,440 --> 00:01:13,080 ONPA@MAIL.NIH.GOV, OR CLICK THE 29 00:01:13,080 --> 00:01:14,960 LIVE FEEDBACK AT THE BOTTOM OF 30 00:01:14,960 --> 00:01:16,640 THE VIDEOCAST SCREEN TO SUBMIT A 31 00:01:16,640 --> 00:01:17,520 QUESTION OR COMMENT. 32 00:01:17,520 --> 00:01:18,360 THE INFORMATION PRESENTED IN 33 00:01:18,360 --> 00:01:21,880 THIS SEMINAR IS MEANT TO 34 00:01:21,880 --> 00:01:23,400 HIGHLIGHT RESEARCH THAT SUPPORTS 35 00:01:23,400 --> 00:01:24,800 THIS TYPE OF INTERVENTION. 36 00:01:24,800 --> 00:01:27,360 PLEASE SPEAK TO YOUR HEALTH CARE 37 00:01:27,360 --> 00:01:29,760 PROFESSIONAL BEFORE BEGINNING 38 00:01:29,760 --> 00:01:30,600 DIETARY INTERVENTION, ESPECIALLY 39 00:01:30,600 --> 00:01:33,400 IF HYPOGLYCEMIA IS A CONCERN AS 40 00:01:33,400 --> 00:01:34,200 WITH DIABETES. 41 00:01:34,200 --> 00:01:37,280 TO BEGIN, LET ME INTRODUCE OUR 42 00:01:37,280 --> 00:01:37,720 SPEAKER. 43 00:01:37,720 --> 00:01:42,440 DR. COURTNEY PETERSON IS 44 00:01:42,440 --> 00:01:43,240 ASSOCIATE PROFESSOR NUTRITION 45 00:01:43,240 --> 00:01:51,000 SCIENCE UNIVERSITY OF ALABAMA 46 00:01:51,000 --> 00:01:53,360 BIRMINGHAM, CONDUCTED THE FIRST 47 00:01:53,360 --> 00:01:54,560 CONTROLLED FEEDING TRIAL OF 48 00:01:54,560 --> 00:01:55,560 INTERMITTENT FASTING IN HUMANS 49 00:01:55,560 --> 00:01:58,680 AND FIRST TO TEST EARLY TIME 50 00:01:58,680 --> 00:02:00,160 RESTRICTED EATING IN HUMANS. 51 00:02:00,160 --> 00:02:02,040 CURRENTLY IS LEAD INVESTIGATOR 52 00:02:02,040 --> 00:02:04,120 OF ACCEPT CLINICAL TRIALS ON 53 00:02:04,120 --> 00:02:07,080 TIME RESTRICTED EATING INCLUDING 54 00:02:07,080 --> 00:02:08,920 TWO OF THE LARGEST. 55 00:02:08,920 --> 00:02:11,000 HER RESEARCH IS FEATURED IN MORE 56 00:02:11,000 --> 00:02:12,920 THAN 50 MEDIA OUTLETS INCLUDING 57 00:02:12,920 --> 00:02:15,440 NBC NIGHTLY NEWS, "NEW YORK 58 00:02:15,440 --> 00:02:16,320 TIMES," WASHINGTON POST, WALL 59 00:02:16,320 --> 00:02:17,880 STREET JOURNAL, GOOD MORNING 60 00:02:17,880 --> 00:02:20,960 AMERICA, AND THE BBC. 61 00:02:20,960 --> 00:02:22,040 WE'RE THRILLED TO HAVE HER 62 00:02:22,040 --> 00:02:23,800 PRESENT TODAY ON THIS 63 00:02:23,800 --> 00:02:26,520 INTERESTING TOPIC. 64 00:02:26,520 --> 00:02:27,240 WELCOME, DR. PETERSON. 65 00:02:27,240 --> 00:02:28,280 >> THANK YOU FOR HAVING ME. 66 00:02:28,280 --> 00:02:32,360 I'M GOING TO TALK ABOUT WHAT WE 67 00:02:32,360 --> 00:02:33,200 KNOW ABOUT INTERMITTENT FASTING 68 00:02:33,200 --> 00:02:34,760 AND CIRCADIAN CLOCK AND TRY TO 69 00:02:34,760 --> 00:02:35,960 ANSWER THE QUESTION, DOES WHEN 70 00:02:35,960 --> 00:02:38,880 YOU EAT AFFECT YOUR HEALTH. 71 00:02:38,880 --> 00:02:41,200 BACK GROUND, MY TRAINING, MY 72 00:02:41,200 --> 00:02:42,600 ORIGINAL TRAINING WAS 73 00:02:42,600 --> 00:02:45,440 ACTUALLY -- I RECEIVED A Ph.D. 74 00:02:45,440 --> 00:02:46,880 IN THEORETICAL PHYSICS AND 75 00:02:46,880 --> 00:02:48,200 SWITCHED FIELDS TO STUDY 76 00:02:48,200 --> 00:02:48,920 NUTRITION AND METABOLISM. 77 00:02:48,920 --> 00:02:50,600 I'LL START THE FIRST HALF OF THE 78 00:02:50,600 --> 00:02:53,000 TALK TELLING THE STORY OF THE 79 00:02:53,000 --> 00:02:55,080 FIELD OF INTERMITTENT FASTING 80 00:02:55,080 --> 00:02:56,840 FROM A METABOLIC ANGLE AND 81 00:02:56,840 --> 00:02:59,000 TRANSITION TALKING ABOUT IT MORE 82 00:02:59,000 --> 00:03:06,760 FROM A BIOLOGICAL ANGLE, TO 83 00:03:06,760 --> 00:03:09,200 PRESENT NEW CONTENT THAT YOU 84 00:03:09,200 --> 00:03:10,640 HAVEN'T SEEN BEFORE. 85 00:03:10,640 --> 00:03:14,240 I HAVE NO DISCLOSURES. 86 00:03:14,240 --> 00:03:17,200 ARE LET'S START AT GROUND ZERO. 87 00:03:17,200 --> 00:03:19,480 SO, INTERMITTENT FASTING IS ANY 88 00:03:19,480 --> 00:03:21,240 SORT OF MEAL TIMING INTERVENTION 89 00:03:21,240 --> 00:03:22,760 OR APPROACH THAT ALTERNATES 90 00:03:22,760 --> 00:03:25,640 PERIODS OF EATING AND EXTENDED 91 00:03:25,640 --> 00:03:26,080 FASTING. 92 00:03:26,080 --> 00:03:27,840 HISTORICALLY THERE'S NO ONE 93 00:03:27,840 --> 00:03:31,920 SINGLE DEFINITION THAT EVERYONE 94 00:03:31,920 --> 00:03:34,520 AGREED TO A MINIMUM NUMBER OF 95 00:03:34,520 --> 00:03:37,160 HOURS FOR SOMETHING TO 96 00:03:37,160 --> 00:03:38,480 CONSTITUTE INTERMITTENT FASTING. 97 00:03:38,480 --> 00:03:40,560 I SERVE ON INTERNATIONAL 98 00:03:40,560 --> 00:03:42,520 CONSENSUS COMMITTEE TRYING TO 99 00:03:42,520 --> 00:03:44,160 HARMONIZE DEFINITIONS OF 100 00:03:44,160 --> 00:03:45,120 INTERMITTENT FASTING, CONVERGING 101 00:03:45,120 --> 00:03:47,440 TOWARDS A 14-HOUR OR LONGER 102 00:03:47,440 --> 00:03:49,280 DEFINITION IN THE HUMAN SPECIES. 103 00:03:49,280 --> 00:03:52,480 I LIKE THIS DEFINITION FOR TWO 104 00:03:52,480 --> 00:03:52,840 REASONS. 105 00:03:52,840 --> 00:03:56,880 ONE, IF YOU LOOK AT DATA FROM 106 00:03:56,880 --> 00:03:58,760 NHANES, ONE OF THE LARGEST 107 00:03:58,760 --> 00:04:02,280 ASSESSMENTS IN THE U.S., IF YOU 108 00:04:02,280 --> 00:04:04,560 LOOK AT THE MEDIAN FASTING AND 109 00:04:04,560 --> 00:04:05,960 EATING DURATION EACH DAY, THE 110 00:04:05,960 --> 00:04:07,640 MEDIAN AMERICAN IS CURRENTLY 111 00:04:07,640 --> 00:04:09,560 EATING OVER A 12-HOUR PERIOD 112 00:04:09,560 --> 00:04:10,720 EACH DAY. 113 00:04:10,720 --> 00:04:13,080 SO FASTING FOR 12 HOURS A DAY. 114 00:04:13,080 --> 00:04:16,160 SECOND, IF YOU LOOK AT DATA ON 115 00:04:16,160 --> 00:04:17,360 SUBSTRATE OXIDATION AS A 116 00:04:17,360 --> 00:04:19,560 FUNCTION OF THE NUMBER OF HOURS 117 00:04:19,560 --> 00:04:20,840 SOMEONE'S BEEN FASTING, WE 118 00:04:20,840 --> 00:04:25,160 REALLY DON'T SEE A BIG 119 00:04:25,160 --> 00:04:29,640 UPREGULATION IN FATTY ACID 120 00:04:29,640 --> 00:04:30,400 OXIDASE OR GLUCONEOGENESIS UNTIL 121 00:04:30,400 --> 00:04:32,480 14 TO 20 HOURS OF FASTING. 122 00:04:32,480 --> 00:04:33,800 SO I THINK THE 14-HOUR 123 00:04:33,800 --> 00:04:34,760 DEFINITION IN THE HUMAN SPECIES 124 00:04:34,760 --> 00:04:37,600 IS A VERY GOOD ONE. 125 00:04:37,600 --> 00:04:39,920 I'LL USE THIS DEFINITION 126 00:04:39,920 --> 00:04:41,560 THROUGHOUT MY TALK TODAY. 127 00:04:41,560 --> 00:04:44,400 THE FIRST RESEARCH WE HAD ON 128 00:04:44,400 --> 00:04:47,000 INTERMITTENT FASTING DATES BACK 129 00:04:47,000 --> 00:04:49,400 TO THE 1940s, FIRST DATA THAT 130 00:04:49,400 --> 00:04:54,360 ENTER MITT -- INTERMITTENT 131 00:04:54,360 --> 00:04:56,080 FASTING EXTENDS THE LIFESPAN, 132 00:04:56,080 --> 00:04:58,040 UNTIL THE MODERN SEMINAR STUDY 133 00:04:58,040 --> 00:05:00,360 ON INTERMITTENT FASTING, WITH AN 134 00:05:00,360 --> 00:05:02,560 ENTERTAINING BACK STORY. 135 00:05:02,560 --> 00:05:05,840 BACK AROUND THE TURN OF THE 136 00:05:05,840 --> 00:05:07,080 CENTURY, MARK MATTSON, ONE OF 137 00:05:07,080 --> 00:05:09,880 THE LARGEST RESEARCHERS IN THE 138 00:05:09,880 --> 00:05:11,280 FIELD OF INTERMITTENT FASTING, 139 00:05:11,280 --> 00:05:13,080 AND HIS POSTDOC WERE HAVING A 140 00:05:13,080 --> 00:05:15,680 DEBATE ON WHETHER THE BENEFICIAL 141 00:05:15,680 --> 00:05:16,720 EFFECTS OF CALORIE RESTRICTION 142 00:05:16,720 --> 00:05:18,560 WERE DUE TO THE REDUCTION IN 143 00:05:18,560 --> 00:05:20,120 CALORIES OR WHETHER IT WAS DUE 144 00:05:20,120 --> 00:05:22,440 TO THE EXTENSION OF THE DAILY 145 00:05:22,440 --> 00:05:23,560 FASTING PERIOD. 146 00:05:23,560 --> 00:05:28,600 A LOT OF MOVED ALSO OF CALORIE 147 00:05:28,600 --> 00:05:29,200 RESTRICTION, RODENT MODELS, 148 00:05:29,200 --> 00:05:32,000 RODENTS EAT IN A SHORTER TIME 149 00:05:32,000 --> 00:05:34,600 PERIOD SO A LONGER FASTING 150 00:05:34,600 --> 00:05:35,040 PERIOD. 151 00:05:35,040 --> 00:05:36,120 TO RESOLVE, THEY CONDUCTED THE 152 00:05:36,120 --> 00:05:37,120 FOLLOWING STUDY. 153 00:05:37,120 --> 00:05:45,040 IN THIS STUDY THEY TOOK RODENTS, 154 00:05:45,040 --> 00:05:47,960 FIRST GROUP CONTROL GROUP, 155 00:05:47,960 --> 00:05:49,160 SECOND WAS CALORIE RESTRICTED, 156 00:05:49,160 --> 00:05:53,040 ATE 35% LESS THAN CALORIE NEEDS, 157 00:05:53,040 --> 00:05:54,360 THE THIRD GROUP PRACTICED 158 00:05:54,360 --> 00:05:56,200 INTERMITTENT FASTING BY DOING 159 00:05:56,200 --> 00:05:56,880 ALTERNATE-DAY FASTING WHERE 160 00:05:56,880 --> 00:05:59,640 EVERY OTHER DAY THEY HAD A 161 00:05:59,640 --> 00:06:04,760 COMPLETE 24-HOUR WATER ONLY 162 00:06:04,760 --> 00:06:05,040 FAST. 163 00:06:05,040 --> 00:06:07,160 THE FOURTH WAS PAIR FED, GIVEN 164 00:06:07,160 --> 00:06:08,800 AS MUCH FOOD BUT CUT CALORIES 165 00:06:08,800 --> 00:06:10,080 THE SAME AMOUNT EVERY DAY. 166 00:06:10,080 --> 00:06:12,200 WHAT THEY FOUND IN THE STUDY 167 00:06:12,200 --> 00:06:17,320 THAT WAS SO REMARKABLE IS THE 168 00:06:17,320 --> 00:06:20,600 INTERMITTENT FASTING GROUP HAD 169 00:06:20,600 --> 00:06:23,480 LOWER GLUCOSE LEVEL, NEURONS 170 00:06:23,480 --> 00:06:25,440 BETTER ABLE TO WITHSTAND 171 00:06:25,440 --> 00:06:26,400 CYTOTOXIC INJURY. 172 00:06:26,400 --> 00:06:28,200 EVEN RELATIVE TO THE PAIR-FED 173 00:06:28,200 --> 00:06:29,480 GROUP THAT EIGHTH THE SAME 174 00:06:29,480 --> 00:06:30,600 NUMBER OF CALORIES. 175 00:06:30,600 --> 00:06:34,600 THIS WAS SOME OF THE FIRST 176 00:06:34,600 --> 00:06:38,800 EVIDENCE THAT IT HAS BENEFITS 177 00:06:38,800 --> 00:06:41,160 INDEPENDENT OF CALORIE 178 00:06:41,160 --> 00:06:41,440 RESTRICTION. 179 00:06:41,440 --> 00:06:45,480 THERE'S BEEN A HUGE FLURRY OF 180 00:06:45,480 --> 00:06:48,160 RESEARCH, SOME FROM THE 181 00:06:48,160 --> 00:06:50,920 METABOLIC AND AGING COMMUNITIES, 182 00:06:50,920 --> 00:06:53,320 OTHERS FROM CHRONOBIOLOGY. 183 00:06:53,320 --> 00:06:54,240 WHAT'S REMARKABLE IS CONSENSUS 184 00:06:54,240 --> 00:06:58,720 IN ANIMAL MODELS IS QUITE GOOD, 185 00:06:58,720 --> 00:07:03,680 WITH A WIDE RANGE OF BENEFITS. 186 00:07:03,680 --> 00:07:07,360 THERE ARE A LOT OF VERY 187 00:07:07,360 --> 00:07:08,800 DIFFERENT SORT OF EFFECTS IN THE 188 00:07:08,800 --> 00:07:09,120 BODY. 189 00:07:09,120 --> 00:07:11,840 THESE INCLUDE THINGS LIKE WEIGHT 190 00:07:11,840 --> 00:07:13,920 LOSS, REDUCTION IN INSULIN LEVEL 191 00:07:13,920 --> 00:07:17,760 RESPECT, AND/OR IGF1 SIGNALING, 192 00:07:17,760 --> 00:07:18,480 INCREASES IN METABOLIC 193 00:07:18,480 --> 00:07:20,920 FLEXIBILITY, THE ABILITY TO 194 00:07:20,920 --> 00:07:22,000 SWITCH BETWEEN BURNING 195 00:07:22,000 --> 00:07:26,720 CARBOHYDRATES VERSUS FAT FOR 196 00:07:26,720 --> 00:07:27,560 FUEL. 197 00:07:27,560 --> 00:07:30,480 INCREASES IN AUTOPHAGY, CHANGES 198 00:07:30,480 --> 00:07:32,440 OR ALTERATIONS IN 199 00:07:32,440 --> 00:07:33,320 NUTRIENT-SENSING PATHWAYS 200 00:07:33,320 --> 00:07:35,720 USUALLY ASSOCIATED WITH 201 00:07:35,720 --> 00:07:38,440 INCREASED LONGEVITY SUCH AS 202 00:07:38,440 --> 00:07:40,600 mTOR, INCREASES IN ANTIOXIDANT 203 00:07:40,600 --> 00:07:42,920 CAPACITY, REDUCTION IN REACTIVE 204 00:07:42,920 --> 00:07:45,560 OXYGEN SPECIES PRODUCTION, 205 00:07:45,560 --> 00:07:49,040 IMPROVEMENT IN MITOCHONDRIAL 206 00:07:49,040 --> 00:07:51,120 FUNCTION, ALTERATIONS IN 207 00:07:51,120 --> 00:07:55,400 NEUROTROPHIC FACTORS SUCH AS 208 00:07:55,400 --> 00:08:01,440 BBNF, HORMESIS AND STRESS 209 00:08:01,440 --> 00:08:03,160 RESISTANCE, FASTING NATRIURESIS, 210 00:08:03,160 --> 00:08:04,520 THERE'S DATA SUGGESTING 211 00:08:04,520 --> 00:08:05,360 PROLONGED FASTING ACTUALLY 212 00:08:05,360 --> 00:08:07,240 ALLOWS THE BODY TO EXCRETE MORE 213 00:08:07,240 --> 00:08:09,320 SODIUM WHICH IN TURN LOWERS 214 00:08:09,320 --> 00:08:10,160 BLOOD PRESSURE. 215 00:08:10,160 --> 00:08:12,800 AND SOME FORMS OF INTERMITTENT 216 00:08:12,800 --> 00:08:15,880 FASTING THOUGH NOT ALL 217 00:08:15,880 --> 00:08:16,760 APPRECIABLY INCREASE KETONE 218 00:08:16,760 --> 00:08:18,640 LEVELS, AND MORE RECENTLY WE 219 00:08:18,640 --> 00:08:19,920 FOUND INTERMITTENT FASTING SEEMS 220 00:08:19,920 --> 00:08:23,200 TO BE QUITE IMPORTANT ON A 221 00:08:23,200 --> 00:08:25,640 MOLECULAR LEVEL FOR MAINTAINING 222 00:08:25,640 --> 00:08:26,960 A STRONG CIRCADIAN RHYTHM. 223 00:08:26,960 --> 00:08:28,400 I HAVE THE INCREDIBLE CHALLENGE 224 00:08:28,400 --> 00:08:35,800 OF SUMMARIZING A HUGE BODY OF 225 00:08:35,800 --> 00:08:36,800 RESEARCH, I COULD CITE 200 226 00:08:36,800 --> 00:08:38,840 STUDIES BUT I ONLY HAVE 40 227 00:08:38,840 --> 00:08:39,800 MINUTES, I'LL DO MY BEST TO GIVE 228 00:08:39,800 --> 00:08:45,560 YOU A TOUR OF THE LITERATURE BT 229 00:08:45,560 --> 00:08:46,440 ASK ME QUESTIONS ON ANYTHING AT 230 00:08:46,440 --> 00:08:48,600 THE END OF THE TALK. 231 00:08:48,600 --> 00:08:51,120 BEFORE WE MOVE TO HUMAN RESEARCH 232 00:08:51,120 --> 00:08:54,760 I WANT TO MENTION WE HAVE THREE 233 00:08:54,760 --> 00:08:56,160 REALLY IMPORTANT SEMINAL STUDIES 234 00:08:56,160 --> 00:08:57,800 ON INTERMITTENT FASTING AND 235 00:08:57,800 --> 00:09:01,200 LIFESPAN IN THE LAST FIVE YEARS. 236 00:09:01,200 --> 00:09:02,520 THOSE REFERENCES ARE PROVIDED AT 237 00:09:02,520 --> 00:09:03,080 THE BOTTOM. 238 00:09:03,080 --> 00:09:08,240 THE FIRST OF THESE WAS A STUDY 239 00:09:08,240 --> 00:09:12,480 OUT OF A LAB IN 2018, ABLE TO 240 00:09:12,480 --> 00:09:15,120 SHOW AT LEAST 40% OF THE 241 00:09:15,120 --> 00:09:16,120 LIFE-EXTENDING BENEFITS OF 242 00:09:16,120 --> 00:09:17,560 CALORIE RESTRICTION ARE IN FACT 243 00:09:17,560 --> 00:09:20,240 NOT DUE TO REDUCTION IN CALORIES 244 00:09:20,240 --> 00:09:23,680 BUT INSTEAD DUE TO INCREASE IN 245 00:09:23,680 --> 00:09:24,200 DAILY FASTING PERIOD. 246 00:09:24,200 --> 00:09:27,520 SO, A LOT OF THE -- AT LEAST A 247 00:09:27,520 --> 00:09:33,760 FAIR A BENEFIT WE THOUGHT WERE 248 00:09:33,760 --> 00:09:35,360 DUE TO CALORIE RESTRICTION WERE 249 00:09:35,360 --> 00:09:36,360 DUE TO INTERMITTENT FASTING. 250 00:09:36,360 --> 00:09:39,520 A STUDY PUBLISHED LAST YEAR IN 251 00:09:39,520 --> 00:09:41,720 "SCIENCE," DONE IN RODENTS, 252 00:09:41,720 --> 00:09:44,040 TRYING TO FIGURE OUT -- TEASING 253 00:09:44,040 --> 00:09:46,720 APART EFFECTS OF CALORIE 254 00:09:46,720 --> 00:09:48,920 RESTRICTION VERSUS INTERMITTENT 255 00:09:48,920 --> 00:09:49,840 FASTING ON LIFESPAN. 256 00:09:49,840 --> 00:09:53,480 IN THIS PARTICULAR STUDY THEY 257 00:09:53,480 --> 00:09:55,160 ENED UP FINDING INTERMITTENT 258 00:09:55,160 --> 00:09:57,960 FASTING INCREASED MORE THAN 259 00:09:57,960 --> 00:09:59,400 CALORIE RESTRICTION. 260 00:09:59,400 --> 00:10:01,360 THEY RANDOMIZED RODENTS TO 1 OF 261 00:10:01,360 --> 00:10:08,240 6 GROUPS, ONE IN GRAY, THE 262 00:10:08,240 --> 00:10:10,680 SECOND JUST DID CALORIE 263 00:10:10,680 --> 00:10:12,160 RESTRICTION, SHOWN IN PURPLE. 264 00:10:12,160 --> 00:10:14,680 THE THIRD AND FOURTH GROUPS WERE 265 00:10:14,680 --> 00:10:16,880 GROUPS THAT DID THE SAME CALORIE 266 00:10:16,880 --> 00:10:20,040 RESTRICTION BUT RESTRICTED THEIR 267 00:10:20,040 --> 00:10:21,560 FOOD INTAKE DURING THE 268 00:10:21,560 --> 00:10:22,680 BIOLOGICAL NIGHT SO LISTED AS 269 00:10:22,680 --> 00:10:24,480 THE DAY BUT DURING THE NORMAL 270 00:10:24,480 --> 00:10:28,720 PERIOD THAT RODENTS SHOULD BE 271 00:10:28,720 --> 00:10:30,240 SLEEPING. 272 00:10:30,240 --> 00:10:33,200 AND THE FOURTH PAIR OF GROUPS 273 00:10:33,200 --> 00:10:34,840 DID CALORIE RESTRICTION BUT THEY 274 00:10:34,840 --> 00:10:37,120 ATE DURING THE NORMAL FEEDING 275 00:10:37,120 --> 00:10:37,440 TIME. 276 00:10:37,440 --> 00:10:39,440 THE REALLY INTERESTING THING IS 277 00:10:39,440 --> 00:10:41,960 RELATIVE TO THE CONTROL GROUP, 278 00:10:41,960 --> 00:10:43,120 CALORIE RESTRICTION INCREASED 279 00:10:43,120 --> 00:10:45,360 LIFESPAN BY 10%. 280 00:10:45,360 --> 00:10:47,320 BUT IF YOU ADDITIONALLY ADDED A 281 00:10:47,320 --> 00:10:48,120 LONGER FASTING PERIOD AT THE 282 00:10:48,120 --> 00:10:50,600 WRONG TIME OF THE DAY, YOU GOT A 283 00:10:50,600 --> 00:10:52,960 20% INCREASE IN LIFESPAN. 284 00:10:52,960 --> 00:10:56,520 BUT IF YOU ALSO MOVE THAT 285 00:10:56,520 --> 00:10:57,840 FASTING PERIOD TO THE RIGHT TIME 286 00:10:57,840 --> 00:11:00,880 OF DAY, SO MEANING AT NIGHT, YOU 287 00:11:00,880 --> 00:11:04,400 GOT A 35% INCREASE IN LIFESPAN. 288 00:11:04,400 --> 00:11:05,800 THE NET PUNCHLINE IS PROLONGED 289 00:11:05,800 --> 00:11:08,040 DAILY FASTING WAS MORE EHE CAN 290 00:11:08,040 --> 00:11:09,040 IFIVE FOR INCREASING LIFESPAN 291 00:11:09,040 --> 00:11:10,640 THAN C.R. 292 00:11:10,640 --> 00:11:12,280 AND WHAT WAS REALLY IMPORTANT 293 00:11:12,280 --> 00:11:15,040 ABOUT THIS STUDY PUBLISHED IN 294 00:11:15,040 --> 00:11:16,120 "SCIENCE," EFFECTS WERE 295 00:11:16,120 --> 00:11:17,080 INDEPENDENT OF BODY WEIGHT, 296 00:11:17,080 --> 00:11:20,400 MEANING THERE WAS NO EVIDENCE OF 297 00:11:20,400 --> 00:11:21,400 IMPROVEMENT IN CARDIOMETABOLIC 298 00:11:21,400 --> 00:11:26,400 HEALTH BUT WE STILL HAD PROFOUND 299 00:11:26,400 --> 00:11:27,760 EFFECTS ON LIFESPAN EXTENSION. 300 00:11:27,760 --> 00:11:29,800 THIS LAST STUDY DONE IN FRUIT 301 00:11:29,800 --> 00:11:32,200 FLIES ESTABLISHED THAT THE MAIN 302 00:11:32,200 --> 00:11:34,640 MECHANISM FOR LIFESPAN EXTENSION 303 00:11:34,640 --> 00:11:38,240 WAS INCREASED IN AUTOPHAGY AT 304 00:11:38,240 --> 00:11:39,600 NIGHTTIME AND DEMONSTRATED WITH 305 00:11:39,600 --> 00:11:42,440 BOTH OVEREXPRESSION MODELS AS 306 00:11:42,440 --> 00:11:44,440 WELL AS KNOCKDOWN MODELS OF 307 00:11:44,440 --> 00:11:45,040 AUTOPHAGY GENES. 308 00:11:45,040 --> 00:11:47,800 THE BIG PICTURE QUESTION IS DO 309 00:11:47,800 --> 00:11:49,680 THESE RESULTS TRANSLATE FROM 310 00:11:49,680 --> 00:11:50,440 ANIMALS INTO HUMANS? 311 00:11:50,440 --> 00:11:54,560 THERE'S SEVERAL REASONS FOR US 312 00:11:54,560 --> 00:11:55,920 TO THINK THE TRANSLATION RESULTS 313 00:11:55,920 --> 00:11:58,760 MAY NOT BE AUTOMATIC SO FOR 314 00:11:58,760 --> 00:12:02,800 INSTANCE, RODENTS ARE NOCTURNAL, 315 00:12:02,800 --> 00:12:07,320 THEY HAVE MULTIPLE SLEEP 316 00:12:07,320 --> 00:12:09,600 EPISODES PER DAY, AND FASTING 317 00:12:09,600 --> 00:12:11,160 FOR 12 HOURS IN A RODENT COULD 318 00:12:11,160 --> 00:12:13,800 BE EQUIVALENT TO A COUPLE DAYS 319 00:12:13,800 --> 00:12:14,440 IN HUMANS. 320 00:12:14,440 --> 00:12:15,440 THIS LEADS TO THREE QUESTIONS 321 00:12:15,440 --> 00:12:18,640 THAT WE AS A FIELD NEED TO 322 00:12:18,640 --> 00:12:18,880 ANSWER. 323 00:12:18,880 --> 00:12:19,840 FIRST IS DOES INTERMITTENT 324 00:12:19,840 --> 00:12:20,600 FASTING WORK IN HUMANS? 325 00:12:20,600 --> 00:12:23,720 THIS IS A QUESTION OF EFFICACY. 326 00:12:23,720 --> 00:12:25,840 SECOND, CAN PEOPLE STICK WITH IT 327 00:12:25,840 --> 00:12:27,040 IN THE LONG TERM, HOW 328 00:12:27,040 --> 00:12:27,680 SUSTAINABLE IS IT? 329 00:12:27,680 --> 00:12:30,440 THE THIRD IS ARE THE EFFECTS 330 00:12:30,440 --> 00:12:33,160 SOLELY DUE TO WEIGHT LOSS? 331 00:12:33,160 --> 00:12:37,120 ONE CRITIQUE I OFTEN AREA, ONE 332 00:12:37,120 --> 00:12:37,920 HYPOTHESIS, INTERMITTENT FASTING 333 00:12:37,920 --> 00:12:39,000 IS JUST ANOTHER FANCY WAY TO 334 00:12:39,000 --> 00:12:40,560 LOSE WEIGHT WHICH MAY BE TRUE, 335 00:12:40,560 --> 00:12:42,480 CERTAINLY FOR CERTAIN TYPES OF 336 00:12:42,480 --> 00:12:43,400 INTERMITTENT FASTING BUT THIS 337 00:12:43,400 --> 00:12:46,520 BEGS THE QUESTION OF MECHANISMS, 338 00:12:46,520 --> 00:12:49,640 WHAT ARE THE UNDERLYING 339 00:12:49,640 --> 00:12:49,920 MECHANISMS? 340 00:12:49,920 --> 00:12:51,920 EVEN IF WE DO FIND SEVERAL TIMES 341 00:12:51,920 --> 00:12:54,200 OF INTERMITTENT FASTING ARE NO 342 00:12:54,200 --> 00:12:55,520 BETTER THAN CALORIE RESTRICTION, 343 00:12:55,520 --> 00:12:59,480 I DON'T THINK THAT'S A LOSS 344 00:12:59,480 --> 00:13:00,960 BECAUSE WHAT'S QUITE INTERESTING 345 00:13:00,960 --> 00:13:04,040 IS INTERMITTENT FASTING, YOU 346 00:13:04,040 --> 00:13:05,320 TYPICALLY ARE SUBSTITUTING 347 00:13:05,320 --> 00:13:06,480 COUNTING TIME INSTEAD OF 348 00:13:06,480 --> 00:13:08,960 COUNTING CALORIES SO INSTEAD OF 349 00:13:08,960 --> 00:13:09,760 MAKING PEOPLE COUNT CALORIES 350 00:13:09,760 --> 00:13:12,200 THEY HAVE TO START AND STOP AT A 351 00:13:12,200 --> 00:13:14,640 CERTAIN TIME OF DAY. 352 00:13:14,640 --> 00:13:15,720 THERE IS PRELIMINARY EVIDENCE 353 00:13:15,720 --> 00:13:17,120 SLOWING PEOPLE HAVE HIGHER LEVEL 354 00:13:17,120 --> 00:13:17,840 OF SATISFACTION. 355 00:13:17,840 --> 00:13:20,240 EVEN IF IT'S NO BETTER THAN 356 00:13:20,240 --> 00:13:22,240 STANDARD CALORIE COUNTING THERE 357 00:13:22,240 --> 00:13:25,080 MAY BE BEHAVIORAL ADVANTAGES TO 358 00:13:25,080 --> 00:13:27,080 INTERMITTENT FASTING. 359 00:13:27,080 --> 00:13:37,560 SO THERE'S SEVERAL TIMES OF 360 00:13:41,320 --> 00:13:42,400 INTERMITTENT FASTING, AND I LIKE 361 00:13:42,400 --> 00:13:43,960 TO GROUP THEM IN THREE 362 00:13:43,960 --> 00:13:46,400 CATEGORIES TO MAKE SENSE OF THE 363 00:13:46,400 --> 00:13:48,640 FIELD AS A WHOLE. 364 00:13:48,640 --> 00:13:49,760 FIRST APPROACH, PERIODIC 365 00:13:49,760 --> 00:13:51,080 FASTING, NOT EVERYONE USES THAT 366 00:13:51,080 --> 00:13:52,360 TERM THE SAME WAY. 367 00:13:52,360 --> 00:13:53,800 BUT THESE ARE APPROACHES WHERE 368 00:13:53,800 --> 00:13:56,320 YOU FAST FOR AT LEAST 24 HOURS 369 00:13:56,320 --> 00:13:57,960 AT A TIME, WATER-ONLY FASTING. 370 00:13:57,960 --> 00:14:00,040 SOME NUMBER OF TIMES PER WEEK, 371 00:14:00,040 --> 00:14:01,880 OR PER MONTH. 372 00:14:01,880 --> 00:14:03,280 EXAMPLE WOULD BE WATER-ONLY 373 00:14:03,280 --> 00:14:08,360 FASTING, ONE DAY A WEEK, OR 374 00:14:08,360 --> 00:14:09,120 ALTERNATE-DAY FASTING, EVERY 375 00:14:09,120 --> 00:14:11,640 OTHER DAY YOU HAVE A COMPLETE 376 00:14:11,640 --> 00:14:12,840 WATER-ONLY FAST. 377 00:14:12,840 --> 00:14:15,560 THE SECOND TYPE OF APPROACH IS 378 00:14:15,560 --> 00:14:17,320 MODIFIED FASTING APPROACHES, YOU 379 00:14:17,320 --> 00:14:20,200 MIGHT ALSO CALL THEM YOUR 380 00:14:20,200 --> 00:14:21,360 INTERMITTENT ENERGY RESTRICTION 381 00:14:21,360 --> 00:14:22,920 APPROACHES, IER. 382 00:14:22,920 --> 00:14:24,320 THESE ARE APPROACHES WHERE 383 00:14:24,320 --> 00:14:27,040 INSTEAD OF HAVING A FULL 24-HOUR 384 00:14:27,040 --> 00:14:29,800 WATER ONLY FAST YOU EAT A LOW 385 00:14:29,800 --> 00:14:31,440 CALORIE DIET, YOUR MODIFIED 386 00:14:31,440 --> 00:14:31,880 FAST. 387 00:14:31,880 --> 00:14:34,840 TYPICALLY ON THOSE DAYS YOU'RE 388 00:14:34,840 --> 00:14:37,000 EATING LESS THAN 800 CALORIES OR 389 00:14:37,000 --> 00:14:40,640 EQUIVALENT OF ONE MEAL THAT DAY. 390 00:14:40,640 --> 00:14:42,360 EXAMPLES INCLUDE ALTERNATE DAY 391 00:14:42,360 --> 00:14:43,800 MODIFIED FASTING, EVERY OTHER 392 00:14:43,800 --> 00:14:45,240 DAY YOU EAT TYPICALLY THE 393 00:14:45,240 --> 00:14:48,640 EQUIVALENT OF ONE MEAL A DAY. 394 00:14:48,640 --> 00:14:49,760 THE FIVE-TWO DIET, PICK TWO DAYS 395 00:14:49,760 --> 00:14:52,600 A WEEK TO HAVE MODIFIED FAST. 396 00:14:52,600 --> 00:14:54,000 FASTING MIMICKING DIET, WHERE 397 00:14:54,000 --> 00:14:56,960 YOU PICK THREE TO FIVE DAYS IN A 398 00:14:56,960 --> 00:14:59,240 ROW TO EAT A LOW CALORIE DIET. 399 00:14:59,240 --> 00:15:01,840 REPEAT THAT SOME NUMBER OF TIMES 400 00:15:01,840 --> 00:15:02,840 PER YEAR. 401 00:15:02,840 --> 00:15:04,040 AND INTERMITTENT ENERGY 402 00:15:04,040 --> 00:15:04,920 RESTRICTION, WHERE YOU TYPICALLY 403 00:15:04,920 --> 00:15:08,000 WILL PICK A WEEK TO EAT A VERY 404 00:15:08,000 --> 00:15:09,280 LOW CALORIE DIET, CYCLE THROUGH 405 00:15:09,280 --> 00:15:15,120 PERIODS OF EATING AND ENERGY 406 00:15:15,120 --> 00:15:15,600 BALANCE. 407 00:15:15,600 --> 00:15:17,520 THE LAST CATEGORY ARE YOUR DAILY 408 00:15:17,520 --> 00:15:18,400 INTERMITTENT FASTING APPROACHES 409 00:15:18,400 --> 00:15:21,360 WHICH ARE NOW KNOWN AS 410 00:15:21,360 --> 00:15:22,760 TIME-RESTRICTED EATING IN 411 00:15:22,760 --> 00:15:23,000 HUMANS. 412 00:15:23,000 --> 00:15:24,080 THESE ARE QUITE DIFFERENT FROM 413 00:15:24,080 --> 00:15:26,960 THE OTHER TYPES OF APPROACHES. 414 00:15:26,960 --> 00:15:29,360 THERE'S NOT A SPECIFIC CALORIE 415 00:15:29,360 --> 00:15:31,000 TARGET YOU'RE TRYING TO MEET ON 416 00:15:31,000 --> 00:15:33,040 EITHER YOUR FASTING OR MODIFIED 417 00:15:33,040 --> 00:15:33,720 FASTING DAYS. 418 00:15:33,720 --> 00:15:37,440 INSTEAD, WHAT YOU'RE TRYING TO 419 00:15:37,440 --> 00:15:39,080 DO IS CONDENSE EATING TO A 420 00:15:39,080 --> 00:15:41,360 SHORTER TIME PERIOD, EITHER BY 421 00:15:41,360 --> 00:15:46,320 EATING BREAKFAST LATER AND/OR 422 00:15:46,320 --> 00:15:46,840 DINNER EARLIER. 423 00:15:46,840 --> 00:15:49,560 ONE OF THE FIRST MODERN STUDIES 424 00:15:49,560 --> 00:15:50,560 OF INTERMITTENT FASTING IN 425 00:15:50,560 --> 00:15:56,480 HUMANS WAS THIS STUDY DONE BY MY 426 00:15:56,480 --> 00:15:57,880 POSTDOCTORAL MENTOR PUBLISHED IN 427 00:15:57,880 --> 00:15:58,640 2005. 428 00:15:58,640 --> 00:16:00,320 IN THIS APPROACH, THEY STUDIED 429 00:16:00,320 --> 00:16:02,040 ALTERNATE DAY FASTING, THE MOST 430 00:16:02,040 --> 00:16:03,600 COMMON FORM OF INTERMITTENT 431 00:16:03,600 --> 00:16:08,440 FASTING STUDIED BACK THEN, ADF. 432 00:16:08,440 --> 00:16:11,560 EVERY OTHER DAY WATER-ONLY FAST. 433 00:16:11,560 --> 00:16:14,440 THEY TOOK 16 PEOPLE AND HAD THEM 434 00:16:14,440 --> 00:16:15,280 TRY ALTERNATE-DAY FASTING. 435 00:16:15,280 --> 00:16:21,200 WHAT THEY FOUND IS INDEED 436 00:16:21,200 --> 00:16:24,240 ALTERNATE DAY FASTING INDUCED 437 00:16:24,240 --> 00:16:30,960 WEIGHT LOSS, PEOPLE WEREN'T 438 00:16:30,960 --> 00:16:33,000 COMPENSATING BY OVEREATING ON 439 00:16:33,000 --> 00:16:33,600 NORMAL DAYS. 440 00:16:33,600 --> 00:16:36,000 IF YOU READ DISCUSSION SESSIONS 441 00:16:36,000 --> 00:16:38,040 HUNGER MARKEDLY INCREASED IN 442 00:16:38,040 --> 00:16:40,600 PARTICIPANTS WITH NO SIGNS OF 443 00:16:40,600 --> 00:16:42,280 ADAPTATION OVER TIME OR WITH 444 00:16:42,280 --> 00:16:46,920 HUNGER LESSENING OVER TIME, SO 445 00:16:46,920 --> 00:16:50,080 PARTICIPANTS WERE EXTREMELY 446 00:16:50,080 --> 00:16:52,400 HANGRY IN THE STUDY, NOT 447 00:16:52,400 --> 00:16:53,840 SUSTAINABLE IN HUMANS. 448 00:16:53,840 --> 00:16:56,240 MOST PEOPLE STOPPED STUDYING 449 00:16:56,240 --> 00:16:58,880 ALTERNATE DAY FASTING IN HUMANS. 450 00:16:58,880 --> 00:17:01,600 I'LL SAY TWO RECENT STUDIES 451 00:17:01,600 --> 00:17:04,000 CITED HERE, THE FIRST COMPARISON 452 00:17:04,000 --> 00:17:06,320 OF ALTERNATE DAY FASTING TO 453 00:17:06,320 --> 00:17:07,120 REGULAR CONTINUOUS ENERGY 454 00:17:07,120 --> 00:17:08,960 RESTRICTION, WHICH YOU CAN THINK 455 00:17:08,960 --> 00:17:13,000 OF AS CONVENTIONAL DAILY 456 00:17:13,000 --> 00:17:13,320 DIETING. 457 00:17:13,320 --> 00:17:18,160 AND RESULTS ON WHETHER ALTERNATE 458 00:17:18,160 --> 00:17:20,000 DAY, RESULTS ARE MIXED. 459 00:17:20,000 --> 00:17:21,680 THE SECOND APPROACH WELL STUDIED 460 00:17:21,680 --> 00:17:24,120 IN HUMANS IS ALTERNATE DAY 461 00:17:24,120 --> 00:17:26,320 MODIFIED FASTING, WHERE EVERY 462 00:17:26,320 --> 00:17:29,320 OTHER DAY YOU HAVE -- YOU EAT 25 463 00:17:29,320 --> 00:17:32,680 TO 35% OF YOUR DAILY CALORIC 464 00:17:32,680 --> 00:17:33,120 NEEDS. 465 00:17:33,120 --> 00:17:42,320 THIS APPROACH HAS BEEN MOST 466 00:17:42,320 --> 00:17:44,080 STUDIED, INCLUDING IMPROVEMENT 467 00:17:44,080 --> 00:17:45,200 IN CARDIOMETABOLIC HEALTH, 468 00:17:45,200 --> 00:17:47,680 INCLUDING WEIGHT LOSS, 469 00:17:47,680 --> 00:17:50,080 CHOLESTEROL LEVELS, FASTING 470 00:17:50,080 --> 00:17:53,840 GLUCOSE LEVELS AND BLOOD 471 00:17:53,840 --> 00:17:54,080 PRESSURE. 472 00:17:54,080 --> 00:17:56,080 SHE ENDED UP DOING A LARGE SCALE 473 00:17:56,080 --> 00:18:00,920 STUDY ON ALTERNATE DAY MODIFIED 474 00:18:00,920 --> 00:18:01,520 FASTING. 475 00:18:01,520 --> 00:18:04,880 IN THIS PARTICULAR STUDY 476 00:18:04,880 --> 00:18:08,160 PUBLISHED IN 2017, SHE TOOK 100 477 00:18:08,160 --> 00:18:09,800 PARTICIPANTS WITH OBESITY, AND 478 00:18:09,800 --> 00:18:11,560 FOR ONE YEAR RANDOMIZED EITHER 479 00:18:11,560 --> 00:18:14,520 TO A WEIGHT STABLE CHROME GROUP, 480 00:18:14,520 --> 00:18:15,040 TO CONTINUOUS ENERGY 481 00:18:15,040 --> 00:18:19,440 RESTRICTION, I'M GOING TO START 482 00:18:19,440 --> 00:18:20,640 USING ABBREVIATION CER, 483 00:18:20,640 --> 00:18:21,840 CONVENTIONAL DAILY DIETING 484 00:18:21,840 --> 00:18:22,640 COUNTING CALORIES AND CUTTING 485 00:18:22,640 --> 00:18:25,560 THEM BY THE SAME AMOUNT EVERY 486 00:18:25,560 --> 00:18:25,880 DAY. 487 00:18:25,880 --> 00:18:27,520 AND THEN ALTERNATE DAY MODIFIED 488 00:18:27,520 --> 00:18:28,720 FASTING, WHERE EVERY OTHER DAY 489 00:18:28,720 --> 00:18:33,480 YOU EAT A VERY LOW CALORIE DIET 490 00:18:33,480 --> 00:18:36,520 THE CER AND ADMF GROUPS WERE 491 00:18:36,520 --> 00:18:38,360 COUNSELED TO HAVE THE SAME NET 492 00:18:38,360 --> 00:18:40,240 REDUCTION IN CALORIES OVER A 493 00:18:40,240 --> 00:18:42,720 WEEK ON AVERAGE. 494 00:18:42,720 --> 00:18:44,760 THE INTERESTING THING, THERE 495 00:18:44,760 --> 00:18:46,600 WERE NO DIFFERENCES BETWEEN 496 00:18:46,600 --> 00:18:47,480 CONTINUOUS ENERGY RESTRICTION 497 00:18:47,480 --> 00:18:49,560 AND ALTERNATE DAY MOD NIGHT 498 00:18:49,560 --> 00:18:51,600 FASTING AT ANY TIME POINT DURING 499 00:18:51,600 --> 00:18:52,160 THE STUDY. 500 00:18:52,160 --> 00:18:55,680 MOREOVER, THERE WERE NO 501 00:18:55,680 --> 00:19:00,040 DIFFERENCES IN FASTING 502 00:19:00,040 --> 00:19:00,600 CARDIOMETABOLIC ENDPOINTS, 503 00:19:00,600 --> 00:19:04,280 VISCERAL FAT OR INFLAMMATORY 504 00:19:04,280 --> 00:19:08,360 MARKERS. 505 00:19:08,360 --> 00:19:10,320 TWO ARE EQUIVALENT, BUT THE 506 00:19:10,320 --> 00:19:13,520 DROPOUT RATE WAS HIGHER FOR THE 507 00:19:13,520 --> 00:19:14,800 ALTERNATE DAY MODIFIED GROUP 508 00:19:14,800 --> 00:19:17,120 SUGGESTING ALTERNATE DAY MOD 509 00:19:17,120 --> 00:19:18,760 NIGHT FASTING WAS LESS FEASIBLE 510 00:19:18,760 --> 00:19:21,240 THAN TRADITIONAL CONTINUOUS 511 00:19:21,240 --> 00:19:24,320 ENERGY RESTRICTION. 512 00:19:24,320 --> 00:19:26,080 THERE WAS A COUPLE SILVER 513 00:19:26,080 --> 00:19:26,320 LININGS. 514 00:19:26,320 --> 00:19:30,240 THEY DID A SMALL NUMBER OF POST 515 00:19:30,240 --> 00:19:31,000 HOC ANALYSES. 516 00:19:31,000 --> 00:19:33,640 IN ONE, THEY LOOKED AT THE 517 00:19:33,640 --> 00:19:36,640 EFFECTS ON VARIOUS GLYCEMIC 518 00:19:36,640 --> 00:19:39,680 OUTCOMES IN INDIVIDUALS WITH 519 00:19:39,680 --> 00:19:42,720 INSULIN RESISTANCE AT THE START. 520 00:19:42,720 --> 00:19:44,520 IN THOSE WITH PROBLEMS IN BLOOD 521 00:19:44,520 --> 00:19:47,760 SUGAR AT THE BEGINNING THEY 522 00:19:47,760 --> 00:19:49,960 FOUND GREATER REDUCTION IN LEVEL 523 00:19:49,960 --> 00:19:51,760 WITH ALTERNATE DAY MODIFIED 524 00:19:51,760 --> 00:19:53,200 FASTING AND GREATER IMPROVEMENT 525 00:19:53,200 --> 00:19:54,080 IN INSULIN RESISTANCE. 526 00:19:54,080 --> 00:19:57,400 THERE MAY BE SOME BENEFITS THERE 527 00:19:57,400 --> 00:20:00,120 FOR IMPROVING BLOOD SUGAR 528 00:20:00,120 --> 00:20:00,600 CONTROL. 529 00:20:00,600 --> 00:20:04,560 THIRD TYPE OF APPROACH I WANT TO 530 00:20:04,560 --> 00:20:07,800 MENTION IS 5:2 DIET, A LESS 531 00:20:07,800 --> 00:20:09,200 EXTREME FORM BECAUSE INSTEAD OF 532 00:20:09,200 --> 00:20:10,280 HAVING MODIFIED FAST EVERY OTHER 533 00:20:10,280 --> 00:20:14,280 DAY, YOU PICK TWO DAYS A WEEK TO 534 00:20:14,280 --> 00:20:15,760 HAVE A MODIFIED FAST. 535 00:20:15,760 --> 00:20:18,400 THOSE DAYS WITH BE CONSECUTIVE 536 00:20:18,400 --> 00:20:19,760 OR NON-CONSECUTIVE. 537 00:20:19,760 --> 00:20:21,880 AND MY READING OF LITERATURE 538 00:20:21,880 --> 00:20:25,960 THERE TEND TO BE MORE POSITIVE 539 00:20:25,960 --> 00:20:28,040 RESULTS FOR APPROACHES WHERE 540 00:20:28,040 --> 00:20:29,440 THEY USE CONSECUTIVE -- WHERE 541 00:20:29,440 --> 00:20:31,640 TWO DAYS ARE CONSECUTIVE, BUT 542 00:20:31,640 --> 00:20:33,080 NONETHELESS WHEN I STARTED 543 00:20:33,080 --> 00:20:34,160 GIVING THESE TALKS THERE WERE 544 00:20:34,160 --> 00:20:38,520 ONLY FOUR STUDIES ON THE 5:2 545 00:20:38,520 --> 00:20:40,000 DIET, WE'RE NOW UP TO 25 546 00:20:40,000 --> 00:20:44,040 CLINICAL TRIALS ON THE 5:2 DIET. 547 00:20:44,040 --> 00:20:48,600 THIS APPROACH IS POPULAR IN 548 00:20:48,600 --> 00:20:49,720 EUROPE AND ENGLAND. 549 00:20:49,720 --> 00:20:51,800 THE STUDY THAT PUT THE 5:2 DIET 550 00:20:51,800 --> 00:21:02,360 ON THE MAP WAS THE 2013 TRIAL , 551 00:21:05,120 --> 00:21:06,440 THREE-MONTH STUDY OF 115 WOMEN 552 00:21:06,440 --> 00:21:11,440 OVERWEIGHT WITH A HISTORY OF 553 00:21:11,440 --> 00:21:14,240 BREAST CANCER, CER COMPARED TO 554 00:21:14,240 --> 00:21:16,080 5:2 DIET, USING CONSECUTIVE 555 00:21:16,080 --> 00:21:16,680 DAYS. 556 00:21:16,680 --> 00:21:18,840 THEY FOUND THE 5:2 DIET WAS MORE 557 00:21:18,840 --> 00:21:21,480 EFFECTIVE AT REDUCING BODY FAT 558 00:21:21,480 --> 00:21:24,400 LEVELS, INSULIN LEVELS AND 559 00:21:24,400 --> 00:21:25,720 INSULIN RESISTANCE THAN 560 00:21:25,720 --> 00:21:26,360 CONTINUOUS ENERGY RESTRICTION, 561 00:21:26,360 --> 00:21:28,680 SOME OF THE FIRST DATA IN HUMANS 562 00:21:28,680 --> 00:21:29,680 INDICATING THAT INTERMITTENT 563 00:21:29,680 --> 00:21:34,600 FASTING MAY BE MORE EFFECTIVE 564 00:21:34,600 --> 00:21:36,160 THAN CONTINUOUS ENERGY 565 00:21:36,160 --> 00:21:38,840 RESTRICTION FOR IMPROVING 566 00:21:38,840 --> 00:21:39,920 CARDIOMETABOLIC HEALTH. 567 00:21:39,920 --> 00:21:41,160 SINCE THEN, WE HAVE FINALLY COME 568 00:21:41,160 --> 00:21:51,680 TO A PLACE WHERE WE HAVE FIVE 569 00:21:53,800 --> 00:21:55,000 ONE-YEAR LONG RANDOMIZED 570 00:21:55,000 --> 00:21:56,360 CONTROLLED TRIALS, IF YOU TRY TO 571 00:21:56,360 --> 00:21:58,920 MAKE SENSE OF THE RESULTS THREE 572 00:21:58,920 --> 00:22:01,840 OF THOSE STUDIES REPORT GREATER 573 00:22:01,840 --> 00:22:04,160 WEIGHT LOSS AT SIX OR TWELVE 574 00:22:04,160 --> 00:22:05,360 WEEKS, OR ALMOST STATISTICALLY 575 00:22:05,360 --> 00:22:08,080 GREATER WEIGHT LOSS AT SIX OR 576 00:22:08,080 --> 00:22:09,200 TWELVE WEEKS. 577 00:22:09,200 --> 00:22:10,840 BUT NONE REPORT SUPERIOR WEIGHT 578 00:22:10,840 --> 00:22:12,680 LOSS OUTCOMES AT THE ONE-YEAR 579 00:22:12,680 --> 00:22:12,920 MARK. 580 00:22:12,920 --> 00:22:16,760 ALL THREE OF THOSE STUDIES THAT 581 00:22:16,760 --> 00:22:18,400 FOUND GREATER SHORT-TERM WEIGHT 582 00:22:18,400 --> 00:22:20,360 LOSS WERE ABLE TO TRACE THE 583 00:22:20,360 --> 00:22:22,080 EVAPORATION OF THOSE BENEFITS AT 584 00:22:22,080 --> 00:22:24,760 THE ONE-YEAR MARK DUE TO 585 00:22:24,760 --> 00:22:26,280 WEIGHTING ADHERENCE, SO IT'S AN 586 00:22:26,280 --> 00:22:29,560 ADHERENCE PROBLEMS WITH THE 5:2 587 00:22:29,560 --> 00:22:29,760 DIET. 588 00:22:29,760 --> 00:22:31,320 OTHER INTERESTING FINDINGS FROM 589 00:22:31,320 --> 00:22:35,480 THESE STUDIES IS ALL OF THESE 590 00:22:35,480 --> 00:22:36,360 STUDIES, PRETTY CONSISTENTLY, 591 00:22:36,360 --> 00:22:40,200 DID NOT FIND IMPROVEMENTS IN 592 00:22:40,200 --> 00:22:40,840 FASTING CARDIOMETABOLIC RISK 593 00:22:40,840 --> 00:22:44,600 FACTORS, BUT ONE AND ONLY THAT 594 00:22:44,600 --> 00:22:46,800 LOOKED AT THE POSTPRANDIAL FOUND 595 00:22:46,800 --> 00:22:50,240 IMPROVEMENT IN C PEPTIDE LEVELS, 596 00:22:50,240 --> 00:22:57,680 INDICATOR OF INSULIN SECRETION 597 00:22:57,680 --> 00:22:59,480 AND TRIGLYCERIDE LEVELS. 598 00:22:59,480 --> 00:23:02,120 WE'RE ONLY SCRATCHING THE 599 00:23:02,120 --> 00:23:07,440 SURFACE AND NEED MORE 600 00:23:07,440 --> 00:23:08,440 POSTPRANDIAL MEASUREMENTS 601 00:23:08,440 --> 00:23:15,200 TENDING TO AFFECT MARKERS AT THE 602 00:23:15,200 --> 00:23:18,080 POSTPRANDIAL LEVEL, LEAVING MORE 603 00:23:18,080 --> 00:23:19,200 ON THE TABLE. 604 00:23:19,200 --> 00:23:22,360 THE FOURTH APPROACH IS 605 00:23:22,360 --> 00:23:24,240 FASTING-MIMICKING DIET, FMD. 606 00:23:24,240 --> 00:23:26,840 THIS IS A LOW-PROTEIN 607 00:23:26,840 --> 00:23:29,360 PLANT-BASED DIET WHERE YOU EAT 608 00:23:29,360 --> 00:23:30,600 700 TO 1100 CALORIES A DAY FOR 609 00:23:30,600 --> 00:23:33,320 THREE TO FIVE DAYS AT A TIME. 610 00:23:33,320 --> 00:23:35,360 YOU REPEAT A NUMBER OF TIMES PER 611 00:23:35,360 --> 00:23:36,880 YEAR, NO MORE OFTEN THAN ONCE A 612 00:23:36,880 --> 00:23:37,320 MONTH. 613 00:23:37,320 --> 00:23:39,840 AND ONE OF THE FIRST LARGE SCALE 614 00:23:39,840 --> 00:23:42,640 STUDIES IN HUMANS WAS THE 615 00:23:42,640 --> 00:23:45,080 THREE-MONTH STUDY IN 100 HEALTHY 616 00:23:45,080 --> 00:23:45,560 ADULTS. 617 00:23:45,560 --> 00:23:46,720 THE CONTROL GROUP WAS 618 00:23:46,720 --> 00:23:48,600 ESSENTIALLY A NO WEIGHT LOSS 619 00:23:48,600 --> 00:23:51,120 CONTROL GROUP. 620 00:23:51,120 --> 00:24:00,240 WHAT THAT FOUND FASTING 621 00:24:00,240 --> 00:24:03,280 MINIMUMMING IMPROVED BROAD BODY 622 00:24:03,280 --> 00:24:04,640 WEIGHT, BODY FAT, IGF1, BLOOD 623 00:24:04,640 --> 00:24:06,520 PRESSURE, NO EFFECT ON GLUCOSE, 624 00:24:06,520 --> 00:24:06,920 LIPIDS. 625 00:24:06,920 --> 00:24:09,960 WE DON'T KNOW HOW IT COMPARES TO 626 00:24:09,960 --> 00:24:13,040 CONTINUOUS ENERGY RESTRICTION 627 00:24:13,040 --> 00:24:14,800 BUT IN THE SHORT TERM FIRST 628 00:24:14,800 --> 00:24:16,560 THREE MONTHS PEOPLE LOSE WEIGHT, 629 00:24:16,560 --> 00:24:18,200 NOT COMPENSATING WHEN THEY GO 630 00:24:18,200 --> 00:24:21,600 OFF THE FASTING MIMICKING DIET. 631 00:24:21,600 --> 00:24:22,800 THE FASTING MINIMUMMINGING DIET 632 00:24:22,800 --> 00:24:25,840 HAS AN INTERESTING BACK STORY, 633 00:24:25,840 --> 00:24:27,720 DEVELOPED BY A DOCTOR WHO HAS 634 00:24:27,720 --> 00:24:30,240 DONE A IMPORTANT WORK ON FASTING 635 00:24:30,240 --> 00:24:33,000 IN CANCER, PARTICULARLY IN 636 00:24:33,000 --> 00:24:35,080 PRE-CLINICAL MODELS. 637 00:24:35,080 --> 00:24:38,120 AND HE WAS INTERESTED IN 638 00:24:38,120 --> 00:24:40,320 APPLYING FASTING IN CANCER 639 00:24:40,320 --> 00:24:42,560 PATIENTS BUT FOUND A LOT OF 640 00:24:42,560 --> 00:24:44,120 TIMES IT WAS HARD TO STICK WITH 641 00:24:44,120 --> 00:24:45,440 THE PROGRAM, ONLY A QUARTER 642 00:24:45,440 --> 00:24:47,000 ACTUALLY WERE WILLING TO TRY 643 00:24:47,000 --> 00:24:49,160 WATER-ONLY FASTING FOR A COUPLE 644 00:24:49,160 --> 00:24:50,480 DAYS AT A TIME. 645 00:24:50,480 --> 00:24:53,280 HE WANTED TO DEVELOP AN 646 00:24:53,280 --> 00:24:54,080 INTERVENTION TO RECAPITULATE A 647 00:24:54,080 --> 00:24:56,280 LOT OF BENEFITS OF FASTING BUT 648 00:24:56,280 --> 00:24:57,400 THAT WOULD BE MORE FEASIBLE TO 649 00:24:57,400 --> 00:24:58,360 DO. 650 00:24:58,360 --> 00:25:00,640 HE DEVELOPED A FASTING MIMICKING 651 00:25:00,640 --> 00:25:00,840 DIET. 652 00:25:00,840 --> 00:25:03,240 AND THE SORT OF THEORY BEHIND 653 00:25:03,240 --> 00:25:04,720 THE FASTING MIMICKING DIET, JUST 654 00:25:04,720 --> 00:25:06,800 FASTING IN GENERAL, IS THAT IT 655 00:25:06,800 --> 00:25:11,960 CAN PROVIDE THE SORT OF DOUBLE 656 00:25:11,960 --> 00:25:13,160 EDGED SWORD TO POTENTIALLY 657 00:25:13,160 --> 00:25:15,920 TARGET OR IMPROVE CANCER 658 00:25:15,920 --> 00:25:16,920 OUTCOMES. 659 00:25:16,920 --> 00:25:21,560 IT'S CALLED THE DIFFERENTIAL 660 00:25:21,560 --> 00:25:23,760 STRESS CESSATION OR RESISTANCE 661 00:25:23,760 --> 00:25:25,200 THEORY, TERMS MEAN SOMETHING 662 00:25:25,200 --> 00:25:26,400 SLIGHTLY DIFFERENT BUT I'LL DO 663 00:25:26,400 --> 00:25:28,360 ENTRY LEVEL DISCUSSION. 664 00:25:28,360 --> 00:25:34,720 THE CORE THEORY IF YOU FAST 665 00:25:34,720 --> 00:25:38,320 NORMAL CELLS DECREASES GLUCOSE 666 00:25:38,320 --> 00:25:39,960 AND NUTRIENTS AND IGF1, AS A 667 00:25:39,960 --> 00:25:44,040 RESULT YOU GET THE CELLS -- THE 668 00:25:44,040 --> 00:25:45,960 CELLS ENTER CELL-PROTECTIVE 669 00:25:45,960 --> 00:25:48,520 MODE, GENERATE LESS OXIDATIVE 670 00:25:48,520 --> 00:25:48,840 STRESS. 671 00:25:48,840 --> 00:25:50,800 APPLY TOXIC INSULT SUCH AS 672 00:25:50,800 --> 00:25:52,080 CHEMOTHERAPY OR RADIATION, SENSE 673 00:25:52,080 --> 00:25:56,280 ARE IN A CELL PROTECTED MODE 674 00:25:56,280 --> 00:25:58,160 SUSTAIN LESS DNA DAMAGE AND DIE 675 00:25:58,160 --> 00:26:01,640 AT LOWER RATE. 676 00:26:01,640 --> 00:26:03,960 CONVERSELY, IF YOU FAST CANCER 677 00:26:03,960 --> 00:26:06,440 CELLS, SAME CONDITIONS, BECAUSE 678 00:26:06,440 --> 00:26:07,800 THEY HAVE ONCOGENIC MUTATIONS 679 00:26:07,800 --> 00:26:10,080 THEY CAN'T ACCESS THESE SAME 680 00:26:10,080 --> 00:26:11,520 CELL PROTECTIVE MECHANISMS, AND 681 00:26:11,520 --> 00:26:13,480 INSTEAD YOU SHIFT THEIR 682 00:26:13,480 --> 00:26:15,880 SUBSTRATE METABOLISM. 683 00:26:15,880 --> 00:26:19,400 YOU CREATE THIS ANTI-WARBURG 684 00:26:19,400 --> 00:26:22,280 LIKE EFFECT AND GET HIGHER 685 00:26:22,280 --> 00:26:23,760 PRODUCTION OF OXIDATIVE STRESS, 686 00:26:23,760 --> 00:26:27,520 IF YOU APPLY CHEMOTHERAPY AND 687 00:26:27,520 --> 00:26:29,800 RADIATION CELLS DIE AT HIGHER 688 00:26:29,800 --> 00:26:31,360 RATE, MORE SELECTIVELY KILLING 689 00:26:31,360 --> 00:26:32,400 CANCER CELLS, MORE SELECTIVELY 690 00:26:32,400 --> 00:26:33,760 PROTECTING NORMAL CELLS AND JUST 691 00:26:33,760 --> 00:26:38,120 STARTING TO SEE SOME FIRST 692 00:26:38,120 --> 00:26:39,240 STUDIES, PRIMARILY ON FASTING 693 00:26:39,240 --> 00:26:40,640 MIMICKING BUT OTHER FORMS OF 694 00:26:40,640 --> 00:26:41,640 INTERMITTENT FASTING BEING 695 00:26:41,640 --> 00:26:45,360 TESTED IN PATIENTS WITH CANCER. 696 00:26:45,360 --> 00:26:48,200 A LOT OF WORK IS BEING DONE IN 697 00:26:48,200 --> 00:26:48,440 ITALY. 698 00:26:48,440 --> 00:26:52,280 HERE IS DATA, NOT A SLAM DUNK 699 00:26:52,280 --> 00:26:58,400 BUT IT IS A STUDY IN 131 700 00:26:58,400 --> 00:26:59,360 PATIENTS WITH HER2-NEGATIVE 701 00:26:59,360 --> 00:27:01,560 STAGE 2 OR STAGE 3 BREAST 702 00:27:01,560 --> 00:27:02,640 CANCER, UNDERPOWERED AND HAD TO 703 00:27:02,640 --> 00:27:06,600 STOP THE TRIAL EARLY BUT 704 00:27:06,600 --> 00:27:08,200 NONETHELESS DID FIND SOME 705 00:27:08,200 --> 00:27:11,680 SUGGESTIVE EVIDENCE THAT THE 706 00:27:11,680 --> 00:27:15,040 FASTING MIMICKING DIET IN THE 707 00:27:15,040 --> 00:27:25,480 INTENTION-TO-TREAT ANALYSIS 708 00:27:28,240 --> 00:27:30,040 IMPROVED RADIOLOGIC 709 00:27:30,040 --> 00:27:30,360 INTERVENTION. 710 00:27:30,360 --> 00:27:37,040 THE FIFTH APPROACH IS 711 00:27:37,040 --> 00:27:37,800 TIME-RESTRICTED EATING, 712 00:27:37,800 --> 00:27:38,760 TIME-RESTRICTED FEEDING, AS IT'S 713 00:27:38,760 --> 00:27:41,400 KNOWN IN ANIMALS. 714 00:27:41,400 --> 00:27:43,520 THESE HAVE MOST RAPIDLY BECOME 715 00:27:43,520 --> 00:27:45,920 POPULAR AMONG THE GENERAL 716 00:27:45,920 --> 00:27:46,360 POPULATION. 717 00:27:46,360 --> 00:27:48,200 IN THESE APPROACH US TYPICALLY 718 00:27:48,200 --> 00:27:50,920 EAT WITHIN A 10-HOUR PERIOD OR 719 00:27:50,920 --> 00:27:52,040 LESS. 720 00:27:52,040 --> 00:27:55,440 AND THE MOST COMMONLY STUDIED 721 00:27:55,440 --> 00:27:57,760 FORM, IN THE LITERATURE, IS 722 00:27:57,760 --> 00:28:00,480 KNOWN AS 16:8 DIET, FAST FOR 16 723 00:28:00,480 --> 00:28:05,280 HOURS A DAY, EAT IN AN 8-HOUR 724 00:28:05,280 --> 00:28:05,840 PERIOD. 725 00:28:05,840 --> 00:28:07,880 WHAT'S SPECIAL ABOUT THESE TYPES 726 00:28:07,880 --> 00:28:09,120 OF APPROACHES RELATIVES TO OTHER 727 00:28:09,120 --> 00:28:10,320 FORMS OF INTERMITTENT FASTING, 728 00:28:10,320 --> 00:28:12,840 THEY ARE FAR MORE CUSTOMIZABLE. 729 00:28:12,840 --> 00:28:15,120 YOU CAN PRACTICE THEM WITH OR 730 00:28:15,120 --> 00:28:16,320 WITHOUT CUTTING CALORIES. 731 00:28:16,320 --> 00:28:17,960 YOU CAN ALSO PRACTICE THEM BY 732 00:28:17,960 --> 00:28:20,400 EATING AT DIFFERENT TIMES OF THE 733 00:28:20,400 --> 00:28:20,800 DAY. 734 00:28:20,800 --> 00:28:23,200 FOR INSTANCE, YOU COULD IN 735 00:28:23,200 --> 00:28:26,240 PRINCIPAL EAT EARLY IN THE DAY, 736 00:28:26,240 --> 00:28:27,640 MOVING DINNER TO SUPER EARLY. 737 00:28:27,640 --> 00:28:30,800 YOU COULD ALSO PRACTICE IT IN 738 00:28:30,800 --> 00:28:32,680 THE MIDDLE OF THE DAY BY 739 00:28:32,680 --> 00:28:33,880 SKIPPING BREAKFAST, OR LATE IN 740 00:28:33,880 --> 00:28:35,600 THE DAY BY SKIPPING BREAKFAST 741 00:28:35,600 --> 00:28:36,400 AND LUNCH. 742 00:28:36,400 --> 00:28:37,680 AND WHAT'S QUITE INTERESTING 743 00:28:37,680 --> 00:28:40,440 ABOUT THE WAY WE'VE STUDIED THIS 744 00:28:40,440 --> 00:28:42,640 SO FAR IS OFTEN WE'VE 745 00:28:42,640 --> 00:28:43,320 IMPLEMENTED INTERVENTIONS 746 00:28:43,320 --> 00:28:44,360 WITHOUT INSTRUCTIONS ON HOW MUCH 747 00:28:44,360 --> 00:28:45,160 TO EAT. 748 00:28:45,160 --> 00:28:46,440 OR WHAT TO EAT. 749 00:28:46,440 --> 00:28:48,320 THESE ARE REALLY RULES OF JUST 750 00:28:48,320 --> 00:28:49,960 TIMENING. 751 00:28:49,960 --> 00:28:51,560 SO IF YOU THINK ABOUT COUNSELING 752 00:28:51,560 --> 00:28:52,920 PATIENTS ON WHAT TO EAT, HOW 753 00:28:52,920 --> 00:28:55,440 MUCH TO EAT, WHEN TO EAT, WE'RE 754 00:28:55,440 --> 00:28:56,840 ONLY LOOKING AT COUNSELING ON 755 00:28:56,840 --> 00:29:00,560 THE WHEN TO EAT SO THE RULES ARE 756 00:29:00,560 --> 00:29:02,880 SIMPLER TO FOLLOW. 757 00:29:02,880 --> 00:29:05,160 THE STUDY THAT'S CREDITED WITH 758 00:29:05,160 --> 00:29:05,920 PUTTING TIME-RESTRICTED EATING 759 00:29:05,920 --> 00:29:07,680 ON THE MAP, THERE ARE OTHER 760 00:29:07,680 --> 00:29:08,760 STUDIES PUBLISHED AROUND THE 761 00:29:08,760 --> 00:29:11,920 SAME TIME, THIS REALLY IMPORTANT 762 00:29:11,920 --> 00:29:15,000 STUDY OUT OF THE SALK INSTITUTE. 763 00:29:15,000 --> 00:29:16,200 THEY COMPARED TIME RESTRICTED 764 00:29:16,200 --> 00:29:23,200 EATING BY EATING OVER AN 8-HOUR 765 00:29:23,200 --> 00:29:24,200 PERIOD VERSUS AD LIBITUM, 766 00:29:24,200 --> 00:29:29,360 SCHEDULES AND HIGH FAT AND 767 00:29:29,360 --> 00:29:30,320 NORMAL CHOW DIET. 768 00:29:30,320 --> 00:29:34,840 ONE REASON IT WAS IMPACTFUL 769 00:29:34,840 --> 00:29:36,560 MATCHED CALORIE INTAKE ACROSS 770 00:29:36,560 --> 00:29:36,800 GROUPS. 771 00:29:36,800 --> 00:29:40,400 TIME RESTRICTED EATING REDUCED 772 00:29:40,400 --> 00:29:44,440 BODY WEIGHT GAIN ON NORMAL AND 773 00:29:44,440 --> 00:29:49,360 HIGH CHOW DIET, IMPROVED GLUCOSE 774 00:29:49,360 --> 00:29:52,400 TOLERANCE ON HIGH FAT, A HOST OF 775 00:29:52,400 --> 00:29:52,960 CARDIOMETABOLIC ENDPOINTS. 776 00:29:52,960 --> 00:29:55,520 THIS IS SOME OF THE FIRST DATA 777 00:29:55,520 --> 00:29:57,720 WE REALLY HAVE SHOWING DAILY 778 00:29:57,720 --> 00:29:58,360 INTERMITTENT FASTING HAS 779 00:29:58,360 --> 00:30:00,560 BENEFITS INDEPENDENT AT LEAST OF 780 00:30:00,560 --> 00:30:01,640 CALORIE INTAKE, EVEN THOUGH 781 00:30:01,640 --> 00:30:03,440 THERE WERE BODY WEIGHT 782 00:30:03,440 --> 00:30:04,280 DIFFERENCES HERE. 783 00:30:04,280 --> 00:30:06,240 AND SINCE THEN THERE HAVE BEEN 784 00:30:06,240 --> 00:30:09,640 MORE THAN 100 ANIMAL STUDIES ON 785 00:30:09,640 --> 00:30:10,640 TIME-RESTRICTED EATING. 786 00:30:10,640 --> 00:30:12,840 THE CONSENSUS IS QUITE GOOD. 787 00:30:12,840 --> 00:30:15,760 I'D SAY IN 75% OR MORE OF THESE 788 00:30:15,760 --> 00:30:17,640 STUDIES, TIME RESTRICTED EATING 789 00:30:17,640 --> 00:30:19,280 REDUCES BODY WEIGHT AND/OR FOOD 790 00:30:19,280 --> 00:30:20,920 INTAKE ESPECIALLY IN RODENT 791 00:30:20,920 --> 00:30:24,560 MODELS OF OBESITY. 792 00:30:24,560 --> 00:30:26,520 IT PREVENTS AND REVERSES TYPE 2 793 00:30:26,520 --> 00:30:28,600 DIABETES, AT LEAST FROM 794 00:30:28,600 --> 00:30:30,360 DIET-INDUCED OBESITY. 795 00:30:30,360 --> 00:30:32,200 IT IMPROVES RANGE OF 796 00:30:32,200 --> 00:30:33,560 CARDIOVASCULAR ENDPOINTS. 797 00:30:33,560 --> 00:30:35,280 SLOWS PROGRESSION OF CANCER AS 798 00:30:35,280 --> 00:30:38,360 WELL AS REDUCES INCIDENCE OF 799 00:30:38,360 --> 00:30:39,600 CANCER. 800 00:30:39,600 --> 00:30:40,440 ALSO SLOWS CERTAIN 801 00:30:40,440 --> 00:30:41,880 NEURODEGENERATIVE CONDITIONS AND 802 00:30:41,880 --> 00:30:42,280 EXTENDS LIFESPAN. 803 00:30:42,280 --> 00:30:44,160 SOME OF THAT DATA FROM ONE OF 804 00:30:44,160 --> 00:30:45,040 THOSE OTHER LIFESPAN STUDIES 805 00:30:45,040 --> 00:30:50,040 THAT I WASN'T ABLE TO SHOW YOU 806 00:30:50,040 --> 00:30:51,280 EARLIER, SHOWING TIME RESTRICTED 807 00:30:51,280 --> 00:30:52,680 EATING EXTENDS LIFESPAN. 808 00:30:52,680 --> 00:30:54,360 ANOTHER IMPORTANT ASPECT THAT 809 00:30:54,360 --> 00:30:57,520 MAKES IT MORE RIPE FOR 810 00:30:57,520 --> 00:31:01,680 TRANSLATION INTO HUMANS OR MORE 811 00:31:01,680 --> 00:31:11,640 PROMISING FROM HEALTH PER 812 00:31:11,640 --> 00:31:12,840 PERSPECTIVES, THE LONGER THE 813 00:31:12,840 --> 00:31:14,480 FASTING PERIOD, THE GREATER THE 814 00:31:14,480 --> 00:31:16,800 BENEFITS BUT THERE DOESN'T SEEM 815 00:31:16,800 --> 00:31:18,480 TO BE A MAGIC THRESHOLD YOU HAVE 816 00:31:18,480 --> 00:31:21,160 TO ACHIEVE PER SE. 817 00:31:21,160 --> 00:31:24,680 IT ALLOWS MORE CUSTOMIZABILITY. 818 00:31:24,680 --> 00:31:26,960 SECOND, TWO RODENT STUDIES FOUND 819 00:31:26,960 --> 00:31:27,720 FOLLOWING TIME RESTRICTED EATING 820 00:31:27,720 --> 00:31:30,480 FIVE DAYS A WEEK, GOING OFF IT 821 00:31:30,480 --> 00:31:36,480 AND PARTYING ON THE WEEKENDS 822 00:31:36,480 --> 00:31:37,240 STILL IMPROVES CARDIOMETABOLIC 823 00:31:37,240 --> 00:31:39,640 HEALTH, NOT TO THE SAME DEGREE 824 00:31:39,640 --> 00:31:42,080 BUT WE DON'T NECESSARILY HAVE TO 825 00:31:42,080 --> 00:31:43,720 FOLLOW THIS SEVEN DAYS A WEEK, 826 00:31:43,720 --> 00:31:45,040 HUMANS DON'T, TO GET SOME SORT 827 00:31:45,040 --> 00:31:45,600 OF BENEFIT. 828 00:31:45,600 --> 00:31:48,200 ONE OF THE FIRST STUDIES WE HAVE 829 00:31:48,200 --> 00:31:49,720 SHOWING THAT TIME RESTRICTED 830 00:31:49,720 --> 00:31:54,560 EATING INDUCED WEIGHT LOSS, THIS 831 00:31:54,560 --> 00:31:57,000 TRIAL HAD PARTICIPANTS EAT OVER 832 00:31:57,000 --> 00:31:58,600 AN 8-HOUR WINDOW FROM 10:00 A.M. 833 00:31:58,600 --> 00:32:01,040 TO 6:00 P.M. 834 00:32:01,040 --> 00:32:02,880 AND THEY DID THIS IN ADULTS WITH 835 00:32:02,880 --> 00:32:05,000 OBESITY AND IMPAIRED TO WEIGHT 836 00:32:05,000 --> 00:32:05,880 STABLE HISTORICAL CONTROLS. 837 00:32:05,880 --> 00:32:08,400 WHAT THEY FOUND IS BY SIMPLY 838 00:32:08,400 --> 00:32:10,120 GIVING PEOPLE TIMING RULES, NOT 839 00:32:10,120 --> 00:32:13,200 WHAT TO EAT OR HOW MUCH, ON 840 00:32:13,200 --> 00:32:13,840 AVERAGE PARTICIPANTS LOST ABOUT 841 00:32:13,840 --> 00:32:18,600 2 1/2% OF THEIR BODY WEIGHT OVER 842 00:32:18,600 --> 00:32:19,880 A 12-WEEK PERIOD. 843 00:32:19,880 --> 00:32:22,000 AND ADHERENCE WAS QUITE GOOD. 844 00:32:22,000 --> 00:32:23,720 SO IT AVERAGED BETWEEN 5 TO 6 845 00:32:23,720 --> 00:32:26,560 DAYS A WEEK, AND WE SEE THIS 846 00:32:26,560 --> 00:32:27,880 CONSISTENTLY ACROSS THE 847 00:32:27,880 --> 00:32:30,120 LITERATURE WITH ONLY A FEW 848 00:32:30,120 --> 00:32:31,080 EXCEPTIONS. 849 00:32:31,080 --> 00:32:31,960 MOST STUDIES REPORTED ADHERENCE 850 00:32:31,960 --> 00:32:36,400 BETWEEN FIVE AND SIX DAYS A 851 00:32:36,400 --> 00:32:36,880 WEEK. 852 00:32:36,880 --> 00:32:41,000 A SLIGHT DECLINE IN ADHERENCE 853 00:32:41,000 --> 00:32:43,240 OVER TIME, MORE FEASIBLE THAN 854 00:32:43,240 --> 00:32:44,080 OTHER FORMS OF INTERMITTENT 855 00:32:44,080 --> 00:32:44,640 FASTING. 856 00:32:44,640 --> 00:32:47,920 TODAY WE'RE UP TO MORE THAN 55 857 00:32:47,920 --> 00:32:49,600 CLINICAL TRIALS ON TIME 858 00:32:49,600 --> 00:32:50,560 RESTRICTED EATING IN HUMANS. 859 00:32:50,560 --> 00:32:53,040 UNFORTUNATELY I WILL SAY MOST OF 860 00:32:53,040 --> 00:32:54,280 THESE STUDIES ARE SMALL, SINGLE 861 00:32:54,280 --> 00:32:56,320 ARM, OR THEY HAVE A WEAK CONTROL 862 00:32:56,320 --> 00:32:56,800 GROUP. 863 00:32:56,800 --> 00:32:58,880 SO QUALITY OF DATA REALLY ISN'T 864 00:32:58,880 --> 00:32:59,640 THERE. 865 00:32:59,640 --> 00:33:01,480 80% OF THE STUDIES FALL INTO 866 00:33:01,480 --> 00:33:03,880 THIS CATEGORY WHERE THERE'S SOME 867 00:33:03,880 --> 00:33:08,280 SORT OF, FOR LACK OF BETTER 868 00:33:08,280 --> 00:33:13,160 WORD, FLAW IN SAMPLE SIZE TOO 869 00:33:13,160 --> 00:33:14,600 SMALL, SINGLE ARM, WEAK CONTROL 870 00:33:14,600 --> 00:33:15,200 GROUP. 871 00:33:15,200 --> 00:33:21,240 WE HAVE FEW STUDIES WITH SAMPLE 872 00:33:21,240 --> 00:33:22,840 SIZES OF MORE THAN 40 PEOPLE PER 873 00:33:22,840 --> 00:33:23,160 GROUP. 874 00:33:23,160 --> 00:33:25,040 THAT'S REALLY NOT ENOUGH 875 00:33:25,040 --> 00:33:28,000 STATISTICAL POWER TO DETECT 876 00:33:28,000 --> 00:33:29,040 IMPORTANT CARDIOMETABOLIC 877 00:33:29,040 --> 00:33:29,280 BENEFITS. 878 00:33:29,280 --> 00:33:30,640 NONETHELESS IF YOU TRY TO MAKE 879 00:33:30,640 --> 00:33:33,000 SENSE OF LITERATURE MANY STUDIES 880 00:33:33,000 --> 00:33:33,920 REPORT BENEFITS. 881 00:33:33,920 --> 00:33:35,960 THESE INCLUDE THINGS LIKE 882 00:33:35,960 --> 00:33:38,920 REDUCTION IN ENERGY INTAKE, 883 00:33:38,920 --> 00:33:41,360 REDUCTIONS IN ADIPOSITY OR BODY 884 00:33:41,360 --> 00:33:43,000 WEIGHT, IMPROVEMENT IN GLYCEMIC 885 00:33:43,000 --> 00:33:45,320 CONTROL OR BLOOD PRESSURE, OR IN 886 00:33:45,320 --> 00:33:49,480 QUALITY OF LIFE. 887 00:33:49,480 --> 00:33:51,360 BUT THERE ARE A LOT OF 888 00:33:51,360 --> 00:33:53,640 CONFLICTING RESULTS AND 889 00:33:53,640 --> 00:33:56,040 PROTOCOLS ARE HIGHLY 890 00:33:56,040 --> 00:33:56,680 HETEROGENEOUS, SOME PROTOCOLS, 891 00:33:56,680 --> 00:33:58,680 FOR INSTANCE, HAVE PEOPLE REDUCE 892 00:33:58,680 --> 00:34:00,440 EATING WINDOW BY ONE TO TWO 893 00:34:00,440 --> 00:34:02,560 HOURS A DAY, OTHERS BY SIX HOURS 894 00:34:02,560 --> 00:34:09,920 A DAY, A LOT OF HETEROGENEITY ON 895 00:34:09,920 --> 00:34:11,360 IMPORTANT ASPECTS OF STUDY 896 00:34:11,360 --> 00:34:11,600 DESIGN. 897 00:34:11,600 --> 00:34:13,560 IF YOU STEP BACK TO MAKE A SENSE 898 00:34:13,560 --> 00:34:16,320 OF ALL THE DATA ON TIME 899 00:34:16,320 --> 00:34:17,840 RESTRICTED EATING AND ASK DOES 900 00:34:17,840 --> 00:34:20,000 IT HELP WITH WEIGHT LOSS, HERE 901 00:34:20,000 --> 00:34:21,800 IS THE ANSWER OR WHERE THE FIELD 902 00:34:21,800 --> 00:34:24,320 IS RIGHT NOW, IN MY OPINION. 903 00:34:24,320 --> 00:34:27,320 SO, A VERY NICE SYSTEMATIC 904 00:34:27,320 --> 00:34:29,040 REVIEW CITED HERE TOOK A LOOK AT 905 00:34:29,040 --> 00:34:32,040 ALL THE STUDIES THAT HAVE BEEN 906 00:34:32,040 --> 00:34:33,840 PUBLISHED, AND FOUND HALF REPORT 907 00:34:33,840 --> 00:34:36,320 A WEIGHT LOSS BENEFIT, AND THE 908 00:34:36,320 --> 00:34:38,720 MEAN EFFECT IS ABOUT 3% OVER 6 909 00:34:38,720 --> 00:34:41,920 TO 8 WEEKS, SO, AGAIN, DURATION 910 00:34:41,920 --> 00:34:46,720 OF STUDY VARIES WIDELY. 911 00:34:46,720 --> 00:34:48,800 THE LAST THREE META-ANALYSES ON 912 00:34:48,800 --> 00:34:50,800 TIME RESTRICTED EATING CONCLUDE 913 00:34:50,800 --> 00:34:52,400 EFFECT, IMPORTANT BECAUSE PRETTY 914 00:34:52,400 --> 00:34:54,280 MUCH UNIVERSALLY ALL INITIAL 915 00:34:54,280 --> 00:34:55,360 META-ANALYSES FOUND NO WEIGHT 916 00:34:55,360 --> 00:34:57,120 LOSS BENEFIT BUT WE'RE GETTING 917 00:34:57,120 --> 00:35:03,240 TO SAMPLE SIZE NOW, WE'RE 918 00:35:03,240 --> 00:35:05,520 WE'RE NOT AT 919 00:35:05,520 --> 00:35:11,760 A THOUSAND, I THINK 900 BASED ON 920 00:35:11,760 --> 00:35:14,920 RECENT MET A ANALYSES, REPORTING 921 00:35:14,920 --> 00:35:16,320 2%. 922 00:35:16,320 --> 00:35:21,520 THEY LOOKED AT RANDOMIZED AND 923 00:35:21,520 --> 00:35:22,640 NON-RANDOMIZED, 2% FOR STUDIES 924 00:35:22,640 --> 00:35:24,760 WITH A GOOD CONTROL GROUP. 925 00:35:24,760 --> 00:35:27,240 WE'RE STARTING TO SEE 926 00:35:27,240 --> 00:35:29,600 META-ANALYSES REPORT BENEFITS IN 927 00:35:29,600 --> 00:35:30,040 OTHER ASPECTS EVER 928 00:35:30,040 --> 00:35:34,640 CARDIOMETABOLIC HEALTH SUCH AS 929 00:35:34,640 --> 00:35:35,400 FASTING GLUCOSE. 930 00:35:35,400 --> 00:35:37,840 MY LAB DID A STUDY, AGAIN 931 00:35:37,840 --> 00:35:39,120 LOOKING AT WEIGHT LOSS IN 932 00:35:39,120 --> 00:35:40,880 RESPONSE TO TIME RESTRICTED 933 00:35:40,880 --> 00:35:41,080 EATING. 934 00:35:41,080 --> 00:35:47,280 WE WERE ABLE TO DO WEIGHT LOSS 935 00:35:47,280 --> 00:35:49,760 MODELING, RATHER THAN RELYING ON 936 00:35:49,760 --> 00:35:50,520 FOOD RECORDS. 937 00:35:50,520 --> 00:35:53,640 THIS WAS A STUDY WE DID IN 90 938 00:35:53,640 --> 00:35:55,400 ADULTS WITH OBESITY. 939 00:35:55,400 --> 00:35:57,160 THEY RANDOMIZED TO 8-HOUR EATING 940 00:35:57,160 --> 00:35:58,160 WINDOW BETWEEN 7:00 A.M. AND 941 00:35:58,160 --> 00:36:01,640 3:00 P.M., THIS IS AN EARLY TIME 942 00:36:01,640 --> 00:36:03,200 RESTRICTED EATING INTERVENTION. 943 00:36:03,200 --> 00:36:04,560 SO PATIENTS MOVED DINNER TO 944 00:36:04,560 --> 00:36:05,880 SUPER EARLY IN THE DAY. 945 00:36:05,880 --> 00:36:09,520 THIS IS A BIT EXTREME BUT JUST 946 00:36:09,520 --> 00:36:12,640 TO DEMONSTRATE THE PRINCIPLE. 947 00:36:12,640 --> 00:36:14,000 VERSUS EATING OVER 12 HOURS OR 948 00:36:14,000 --> 00:36:14,240 LONGER. 949 00:36:14,240 --> 00:36:16,080 WE FOUND THE GROUP THAT DID 950 00:36:16,080 --> 00:36:17,160 EARLY TIME RESTRICTED EATING 951 00:36:17,160 --> 00:36:19,880 LOST MORE WEIGHT AND WHEN WE DID 952 00:36:19,880 --> 00:36:21,440 MODELING OF THESE WEIGHT LOSS 953 00:36:21,440 --> 00:36:23,400 TRAJECTORIES WE FOUND THAT THE 954 00:36:23,400 --> 00:36:27,440 CALORIE DEFICIT WAS EQUIVALENT 955 00:36:27,440 --> 00:36:28,680 TO CUTTING CALORIES BY 214 956 00:36:28,680 --> 00:36:31,120 CALORIES A DAY LOOKING AT ALL 957 00:36:31,120 --> 00:36:31,760 PARTICIPANTS, INCLUDING PEOPLE 958 00:36:31,760 --> 00:36:35,240 WHO DIDN'T STICK WITH THE 959 00:36:35,240 --> 00:36:35,520 PROTOCOL. 960 00:36:35,520 --> 00:36:39,720 EFFECT ROSE TO 350 CALORIES A 961 00:36:39,720 --> 00:36:41,480 DAY IN THOSE WHO AT HEARD FIVE 962 00:36:41,480 --> 00:36:44,760 DAYS A WEEK, EVERY WEEK OF THE 963 00:36:44,760 --> 00:36:45,200 STUDY. 964 00:36:45,200 --> 00:36:47,520 WE ALSO FOUND IMPROVEMENTS IN 965 00:36:47,520 --> 00:36:49,280 MOOD AND DIASTOLIC BLOOD 966 00:36:49,280 --> 00:36:49,560 PRESSURE. 967 00:36:49,560 --> 00:36:55,280 ONE REALLY INTERESTING FINDING 968 00:36:55,280 --> 00:36:56,240 RELATES TO SLEEP. 969 00:36:56,240 --> 00:36:58,400 WE FOUND THAT EARLY TIME 970 00:36:58,400 --> 00:36:59,320 RESTRICTED EATING TO OUR 971 00:36:59,320 --> 00:37:02,280 SURPRISE, MOST OF THE PREVIOUS 972 00:37:02,280 --> 00:37:03,560 LITERATURE WAS NULL, BUT IN THIS 973 00:37:03,560 --> 00:37:06,440 STUDY WE FOUND EARLY TIME 974 00:37:06,440 --> 00:37:07,800 RESTRICTED EATING SHORTENED 975 00:37:07,800 --> 00:37:09,920 SLEEP DURATION BY 30 MINUTES 976 00:37:09,920 --> 00:37:11,600 RELATIVE TO CONTROL GROUP. 977 00:37:11,600 --> 00:37:13,760 FIRST WE THOUGHT THIS IS A 978 00:37:13,760 --> 00:37:14,560 NEGATIVE EFFECT, MAYBE 979 00:37:14,560 --> 00:37:16,280 PARTICIPANTS ARE HUNGRY AT 980 00:37:16,280 --> 00:37:17,280 NIGHT, NOT FALLING ASLEEP, OR 981 00:37:17,280 --> 00:37:18,680 MAYBE THEY HAVE TO GET UP 982 00:37:18,680 --> 00:37:20,560 EARLIER TO PREP MEALS FOR THE 983 00:37:20,560 --> 00:37:20,760 DAY. 984 00:37:20,760 --> 00:37:25,280 BUT WE DIDN'T FIND ANY EVIDENCE 985 00:37:25,280 --> 00:37:29,640 OF EITHER OF THOSE BAILED ON 986 00:37:29,640 --> 00:37:31,360 CORRELATION ANALYSIS. 987 00:37:31,360 --> 00:37:33,320 PARTICIPANTS REPORTED FEELING 988 00:37:33,320 --> 00:37:35,760 MORE ENERGETIC, LESS FATIGUE 989 00:37:35,760 --> 00:37:39,240 DESPITE SLEEPING LESS. 990 00:37:39,240 --> 00:37:40,240 WE'VE PUT OUT HYPOTHESIS, 991 00:37:40,240 --> 00:37:42,360 BECAUSE THERE'S A LONGER TIME TO 992 00:37:42,360 --> 00:37:44,200 REST AND REPAIR, ON A VERY 993 00:37:44,200 --> 00:37:45,680 SIMPLISTIC LEVEL, MAYBE THE NEED 994 00:37:45,680 --> 00:37:47,440 FOR SLEEP IS LESS. 995 00:37:47,440 --> 00:37:48,240 WE'RE FASCINATED BY THIS 996 00:37:48,240 --> 00:37:51,480 QUESTION AND WOULD LOVE TO SEE 997 00:37:51,480 --> 00:37:55,360 MORE STUDIES ON THIS TOPIC. 998 00:37:55,360 --> 00:37:59,640 GOING BACK TO THE MAIN LINE OF 999 00:37:59,640 --> 00:38:00,600 WEIGHT LOSS RESEARCH, WE'VE -- 1000 00:38:00,600 --> 00:38:02,040 MY LAB HAS BEEN INTERESTED IN 1001 00:38:02,040 --> 00:38:04,000 UNDERSTANDING WHAT ARE THE 1002 00:38:04,000 --> 00:38:04,760 MECHANISMS UNDERLYING THIS 1003 00:38:04,760 --> 00:38:05,440 GREATER WEIGHT LOSS. 1004 00:38:05,440 --> 00:38:07,160 WE DID A REALLY NICE STUDY BACK 1005 00:38:07,160 --> 00:38:10,560 A FEW YEARS AGO TRYING TO 1006 00:38:10,560 --> 00:38:11,360 UNDERSTAND DO INTERMITTENT 1007 00:38:11,360 --> 00:38:12,960 FASTING INTERVENTIONS SUCH AS 1008 00:38:12,960 --> 00:38:14,520 TIME RESTRICTED EATING INDUCE 1009 00:38:14,520 --> 00:38:16,600 WEIGHT LOSS BY DECREASING 1010 00:38:16,600 --> 00:38:19,360 APPETITE OR BY INCREASING ENERGY 1011 00:38:19,360 --> 00:38:20,080 EXPENDITURE? 1012 00:38:20,080 --> 00:38:24,840 WE DID A STUDY IN 11 ADULTS WITH 1013 00:38:24,840 --> 00:38:26,280 OVERWEIGHT, AND RANDOMIZED THEM 1014 00:38:26,280 --> 00:38:27,720 TO EAT OVER 6-HOUR PERIOD FROM 1015 00:38:27,720 --> 00:38:31,360 8:00 A.M. TO 2:00 P.M., OR TO 1016 00:38:31,360 --> 00:38:34,200 EAT OVER A 12-HOUR PERIOD, A 1017 00:38:34,200 --> 00:38:35,440 CROSSOVER STUDY SO EACH PATIENT 1018 00:38:35,440 --> 00:38:37,520 DOES THEIR OWN CONTROL AND TRIED 1019 00:38:37,520 --> 00:38:38,360 BOTH EATING SCHEDULES. 1020 00:38:38,360 --> 00:38:40,680 AND ON THE FOURTH DAY OF THE 1021 00:38:40,680 --> 00:38:43,200 EATING SCHEDULE, WE PUT THEM IN 1022 00:38:43,200 --> 00:38:44,160 A RESPIRATORY CHAMBER AND 1023 00:38:44,160 --> 00:38:50,320 MEASURED HOW MANY CALORIES THEY 1024 00:38:50,320 --> 00:38:52,200 BURNED, WE FOUND NO DIFFERENCES 1025 00:38:52,200 --> 00:38:54,080 IN EXPENDITURE SO WE THINK THE 1026 00:38:54,080 --> 00:38:57,120 APPROACHES DO NOT SEEM TO 1027 00:38:57,120 --> 00:38:58,680 MATERIALLY AFFECT ENERGY 1028 00:38:58,680 --> 00:39:01,280 EXPENDITURE OR EFFECTS ARE 1029 00:39:01,280 --> 00:39:03,120 SMALL, POWERED TO DETECT 1030 00:39:03,120 --> 00:39:04,800 80-CALORIE A DAY DIFFERENCES BUT 1031 00:39:04,800 --> 00:39:08,920 DECREASED APPETITES AND WHEN WE 1032 00:39:08,920 --> 00:39:10,120 MEASURED SUBJECTIVE HUNGER OVER 1033 00:39:10,120 --> 00:39:12,320 THE DAY IT WAS MORE EVEN KEELED 1034 00:39:12,320 --> 00:39:13,320 OVER THE DAY, THE OP ISN'T OF 1035 00:39:13,320 --> 00:39:15,400 WHAT I WOULD HAVE EXPECTED. 1036 00:39:15,400 --> 00:39:16,800 I WOULD HAVE EXPECTED GREATER 1037 00:39:16,800 --> 00:39:18,240 SWINGS IN HUNGER BUT WE DIDN'T 1038 00:39:18,240 --> 00:39:18,760 SEE THAT. 1039 00:39:18,760 --> 00:39:21,840 MOREOVER WHEN WE LOOKED AT 1040 00:39:21,840 --> 00:39:22,960 APPETITE HORMONES, OBJECTIVE 1041 00:39:22,960 --> 00:39:25,440 MEASURE OF APPETITE, WE FOUND 1042 00:39:25,440 --> 00:39:27,440 DECREASES IN ACTIVE GHRELIN 1043 00:39:27,440 --> 00:39:30,840 LEVELS IN THE MORNING, INCREASES 1044 00:39:30,840 --> 00:39:34,880 IN PYY IN THE EVENING, AND 1045 00:39:34,880 --> 00:39:36,640 ALTERATIONS IN LEPTIN LEVELS. 1046 00:39:36,640 --> 00:39:39,600 OUTSIDE OF THE TOPIC OF OBESITY 1047 00:39:39,600 --> 00:39:41,520 OR ENERGY METABOLISM THERE'S 1048 00:39:41,520 --> 00:39:42,880 ALSO DATA SUGGESTING 1049 00:39:42,880 --> 00:39:45,040 TIME-RESTRICTED EATING AFFECTS 1050 00:39:45,040 --> 00:39:46,360 OTHER ASPECTS OF CARDIOMETABOLIC 1051 00:39:46,360 --> 00:39:46,920 HEALTH. 1052 00:39:46,920 --> 00:39:49,200 THIS IS FROM THE LARGEST STUDY 1053 00:39:49,200 --> 00:39:51,880 IN PATIENTS WITH TYPE 2 1054 00:39:51,880 --> 00:39:53,960 DIABETES, 12-WEEK TRIAL, 120 1055 00:39:53,960 --> 00:39:55,440 ADULTS OUT OF CHINA. 1056 00:39:55,440 --> 00:39:57,200 RANDOMIZED TO EAT OVER 10-HOUR 1057 00:39:57,200 --> 00:39:58,520 PERIOD STARTING AT 8:00 A.M., 1058 00:39:58,520 --> 00:40:01,680 ENDING AT 6:00 P.M., OR NO 1059 00:40:01,680 --> 00:40:02,800 INSTRUCTIONS ON WHEN TO EAT. 1060 00:40:02,800 --> 00:40:08,120 WHAT THEY FOUND IS THAT TIME 1061 00:40:08,120 --> 00:40:12,880 RESTRICTED EATING IMPROVED 1062 00:40:12,880 --> 00:40:15,480 HEMOGLOBIN A1c, REDUCED 1063 00:40:15,480 --> 00:40:18,520 FASTING GLUCOSE AND REDUCED 1064 00:40:18,520 --> 00:40:24,000 INSULIN LEVELS, RESISTANCE, 1065 00:40:24,000 --> 00:40:25,320 LIPID LEVELS. 1066 00:40:25,320 --> 00:40:28,040 WE'RE STARTING TO SEE STUDIES ON 1067 00:40:28,040 --> 00:40:29,280 METABOLIC SYNDROME, PREDIABETES, 1068 00:40:29,280 --> 00:40:30,960 EVEN SOME CONDITIONS LIKE PCOS 1069 00:40:30,960 --> 00:40:31,800 AND M.S. 1070 00:40:31,800 --> 00:40:34,240 HERE'S DATA FROM ONE OF THOSE 1071 00:40:34,240 --> 00:40:38,440 STUDIES IN ADULTS WITH METABOLIC 1072 00:40:38,440 --> 00:40:38,720 SYNDROME. 1073 00:40:38,720 --> 00:40:41,760 THIS WAS ONE OF THE FIRST 1074 00:40:41,760 --> 00:40:45,240 STUDIES DURN IN PATIENTS WITH 1075 00:40:45,240 --> 00:40:46,880 METABOLIC SYNDROME. 1076 00:40:46,880 --> 00:40:48,640 AND THEY WERE INSTRUCTED TO 1077 00:40:48,640 --> 00:40:49,880 SELECT A 10-HOUR WINDOW DURING 1078 00:40:49,880 --> 00:40:52,480 THE DAY TO PRACTICE TIME 1079 00:40:52,480 --> 00:40:55,200 RESTRICTED EATING, AND THEY 1080 00:40:55,200 --> 00:40:56,760 FOUND TIME RESTRICTED EATING 1081 00:40:56,760 --> 00:41:07,240 REDUCED BODY WEIGHT, BODY FAT 1082 00:41:10,680 --> 00:41:13,840 WAIST CIRCUMFERENCE. 1083 00:41:13,840 --> 00:41:18,280 MY LAB WAS QUITE INTERESTED 1084 00:41:18,280 --> 00:41:20,600 SEVERAL YEARS AGO AND DESIGNED 1085 00:41:20,600 --> 00:41:31,120 TO DETERMINE TRE CAN IMPROVE 1086 00:41:32,720 --> 00:41:34,400 CARDIOMETABOLIC HEALTH. 1087 00:41:34,400 --> 00:41:37,200 THE FIRST SCHEDULE WAS 6-HOUR, 1088 00:41:37,200 --> 00:41:39,200 STARTING AT 8:00 A.M., ENDING 1089 00:41:39,200 --> 00:41:40,400 2:00 P.M. 1090 00:41:40,400 --> 00:41:42,480 SECOND WAS EATING OVER A 12-HOUR 1091 00:41:42,480 --> 00:41:43,240 PERIOD. 1092 00:41:43,240 --> 00:41:46,240 WE HAVE LARGE CHANGES IN FASTING 1093 00:41:46,240 --> 00:41:47,240 DURATION. 1094 00:41:47,240 --> 00:41:49,840 WE FOUND TIME RESTRICTED EATING 1095 00:41:49,840 --> 00:41:51,360 HAS BENEFITS INDEPENDENT OF 1096 00:41:51,360 --> 00:41:53,880 WEIGHT LOSS OR FOOD INTAKE 1097 00:41:53,880 --> 00:41:56,400 BECAUSE WE MATCHED FOOD INTAKE 1098 00:41:56,400 --> 00:41:58,040 ACROSS EATING SCHEDULES SO 1099 00:41:58,040 --> 00:41:59,480 PARTICIPANTS WERE FED ENERGY 1100 00:41:59,480 --> 00:42:01,000 BALANCE, DIDN'T GAIN OR LOSE 1101 00:42:01,000 --> 00:42:02,960 WEIGHT, EVERYTHING WAS PERFECTLY 1102 00:42:02,960 --> 00:42:03,360 MATCHED. 1103 00:42:03,360 --> 00:42:06,800 WE FOUND THAT INSULIN RESISTANCE 1104 00:42:06,800 --> 00:42:10,200 DURING ORAL GLUCOSE TOLERANCE 1105 00:42:10,200 --> 00:42:15,240 TEST IMPROVED, AND BETA CELL 1106 00:42:15,240 --> 00:42:16,040 RESPONSIVENESS, TO PRODUCE 1107 00:42:16,040 --> 00:42:19,200 INSULIN IN RESPONSE TO RISING 1108 00:42:19,200 --> 00:42:23,000 GLUCOSE LEVELS, LARGE IMROVMENTS 1109 00:42:23,000 --> 00:42:25,440 IN BLOOD PRESSURE, AS WELL AS 1110 00:42:25,440 --> 00:42:26,360 MODEST IMPROVEMENTS IN OXIDATIVE 1111 00:42:26,360 --> 00:42:27,280 STRESS LEVELS. 1112 00:42:27,280 --> 00:42:29,800 WE FOUND NO IMPROVEMENTS IN 1113 00:42:29,800 --> 00:42:31,560 LIPID LEVELS SO DON'T THINK OUR 1114 00:42:31,560 --> 00:42:34,960 LEADING THEORY RIGHT NOW IS ANY 1115 00:42:34,960 --> 00:42:36,480 IMPROVEMENT IN LIPID LEVELS ARE 1116 00:42:36,480 --> 00:42:38,120 DRIVEN BY WEIGHT LOSS, NO 1117 00:42:38,120 --> 00:42:38,760 IMPROVEMENT IN MAJOR 1118 00:42:38,760 --> 00:42:41,600 INFLAMMATORY MARKERS OR HEART 1119 00:42:41,600 --> 00:42:42,040 RATE. 1120 00:42:42,040 --> 00:42:45,880 SINCE THEN RESULTS HAVE BEEN 1121 00:42:45,880 --> 00:42:46,400 REPLICATED BY SEVEN OR 1122 00:42:46,400 --> 00:42:47,440 RANDOMIZED CONTROLLED TRIALS, 1123 00:42:47,440 --> 00:42:49,840 THERE ARE NOW EIGHT THAT 1124 00:42:49,840 --> 00:42:51,600 REPORTED BENEFITS INDEPENDENT OF 1125 00:42:51,600 --> 00:42:52,880 CALORIE RESTRICTION, CONSENSUS 1126 00:42:52,880 --> 00:42:56,520 IS EXCELLENT IN WELL CAREFULLY 1127 00:42:56,520 --> 00:42:57,280 DONE METABOLIC TYPE STUDIES. 1128 00:42:57,280 --> 00:42:59,400 HERE IS DATA FROM ANOTHER ONE, 1129 00:42:59,400 --> 00:43:01,720 TWO WEEKS TESTING EARLY TIME 1130 00:43:01,720 --> 00:43:02,520 RESTRICTED EATING. 1131 00:43:02,520 --> 00:43:10,040 THEY FOUND IMPROVEMENT IN OF 1132 00:43:10,040 --> 00:43:16,400 GLUCOSE UPTAKE AND BRANCH CHAIN 1133 00:43:16,400 --> 00:43:16,600 UPTAKE. 1134 00:43:16,600 --> 00:43:19,560 WE FOUND ONLY 4 DAYS OF EARLY 1135 00:43:19,560 --> 00:43:21,080 TIME RESTRICTED EATING ACTUALLY 1136 00:43:21,080 --> 00:43:23,040 LOWERED 24 HOUR GLUCOSE LEVELS 1137 00:43:23,040 --> 00:43:24,600 BY THE SOLID LINE. 1138 00:43:24,600 --> 00:43:26,320 WHAT'S SUPER INTERESTING, YOU 1139 00:43:26,320 --> 00:43:28,000 CAN SEE VERY BEAUTIFULLY 1140 00:43:28,000 --> 00:43:29,080 ILLUSTRATED, IF YOU ONLY 1141 00:43:29,080 --> 00:43:37,160 MEASURED FASTING GLUE FASTING U 1142 00:43:37,160 --> 00:43:38,920 WOULD MISS CHANGES AT 1143 00:43:38,920 --> 00:43:39,920 POSTPRANDIAL LEVELS. 1144 00:43:39,920 --> 00:43:44,520 FOOD INTAKE OR CALORIE INTAKE 1145 00:43:44,520 --> 00:43:45,360 ARE MATCHED, INSULIN 1146 00:43:45,360 --> 00:43:46,560 SENSITIVITY, BLOOD PRESSURE, 1147 00:43:46,560 --> 00:43:48,640 BODY FAT. 1148 00:43:48,640 --> 00:43:51,280 THERE HAVE BEEN PROMINENT NULL 1149 00:43:51,280 --> 00:43:52,200 STUDIES. 1150 00:43:52,200 --> 00:43:54,120 HERE IS DATA FROM ONE, PUBLISHED 1151 00:43:54,120 --> 00:43:56,320 IN JAMA INTERNAL MEDICINE, THREE 1152 00:43:56,320 --> 00:43:57,840 YEARS AGO. 1153 00:43:57,840 --> 00:43:59,480 THEY COMPARED TIME-RESTRICTED 1154 00:43:59,480 --> 00:44:01,280 EATING BY SKIPPING BREAKFAST, 1155 00:44:01,280 --> 00:44:03,000 EATING IN AN 8-HOUR PERIOD 1156 00:44:03,000 --> 00:44:05,960 BETWEEN 12 AND 8:00 P.M., VERSUS 1157 00:44:05,960 --> 00:44:07,040 THREE MEALS A DAY. 1158 00:44:07,040 --> 00:44:09,000 THE ROLE, THEY HAD TO EAT 1159 00:44:09,000 --> 00:44:09,280 BREAKFAST. 1160 00:44:09,280 --> 00:44:10,640 THEY WEREN'T ALLOWED TO EAT 1161 00:44:10,640 --> 00:44:15,560 THREE MEALS LATER IN THE DAY. 1162 00:44:15,560 --> 00:44:19,120 THEY FOUND IN 116 ADULTS OVER 12 1163 00:44:19,120 --> 00:44:20,080 WEEKS, ABSOLUTELY NO DIFFERENCES 1164 00:44:20,080 --> 00:44:22,920 IN BODY WEIGHT BETWEEN THE 1165 00:44:22,920 --> 00:44:25,440 GROUPS, MEASURED A VERY LARGE 1166 00:44:25,440 --> 00:44:27,760 LIST OF CARDIOMETABOLIC RISK 1167 00:44:27,760 --> 00:44:28,840 FACTORS AND COMPOSITION RISK 1168 00:44:28,840 --> 00:44:34,880 FACTORS, ALL NULL. 1169 00:44:34,880 --> 00:44:35,880 ONE INTERESTING THING, 1170 00:44:35,880 --> 00:44:36,640 PARTICIPANTS STARTED GOING TO 1171 00:44:36,640 --> 00:44:37,600 BET LATER AT NIGHT. 1172 00:44:37,600 --> 00:44:40,240 AT LEAST WITH THIS FORM OF TIME 1173 00:44:40,240 --> 00:44:42,840 RESTRICTED EATING THAT MAY BE 1174 00:44:42,840 --> 00:44:45,120 AFFECTING SLEEP PATTERNS, DOING 1175 00:44:45,120 --> 00:44:46,040 TIME-RESTRICTED EATING BY EATING 1176 00:44:46,040 --> 00:44:49,160 LATER IN THE DAY. 1177 00:44:49,160 --> 00:44:50,280 THERE'S DATA THAT LATE 1178 00:44:50,280 --> 00:44:57,600 TIME-RESTRICTED EATING WHICH 1179 00:44:57,600 --> 00:44:59,240 I'LL DEFINE, YOU COULD CALL THIS 1180 00:44:59,240 --> 00:45:02,240 MIDDAY OR MIDDLE OF THE DAY 1181 00:45:02,240 --> 00:45:03,840 TIME-RESTRICTED EATING BY 1182 00:45:03,840 --> 00:45:05,600 SKIPPING BREAKFAST, THIS IS 1183 00:45:05,600 --> 00:45:07,040 TIME-RESTRICTED BY SKIPPING 1184 00:45:07,040 --> 00:45:10,640 BREAKFAST AND LUNCH. 1185 00:45:10,640 --> 00:45:12,080 SO THE LATE RESTRICTED EATING, 1186 00:45:12,080 --> 00:45:14,240 DATA IS NULL OR NEGATIVE. 1187 00:45:14,240 --> 00:45:16,960 HERE IS FROM ONE, 8-WEEK 1188 00:45:16,960 --> 00:45:19,320 CROSSOVER STUDY, THEY COMPARED 1189 00:45:19,320 --> 00:45:20,360 TIME-RESTRICTED EATING BEFORE 1190 00:45:20,360 --> 00:45:22,800 THE TERM WAS INVENTED BUT 1191 00:45:22,800 --> 00:45:25,400 COMPARED EATING IN A 4-HOUR 1192 00:45:25,400 --> 00:45:29,720 PERIODS BETWEEN 5 AND 9:00 P.M. 1193 00:45:29,720 --> 00:45:33,400 VERSUS THREE MEETS A-- MEALS 1194 00:45:33,400 --> 00:45:38,440 ACROSS THE DAY EATING BREAKFAST. 1195 00:45:38,440 --> 00:45:40,720 THIS WORSENED POSTPRANDIAL 1196 00:45:40,720 --> 00:45:44,480 GLUCOSE LEVELS, EVIDENT AT THE 1197 00:45:44,480 --> 00:45:47,440 POSTPRANDIAL LEVEL, THEY FOUND 1198 00:45:47,440 --> 00:45:49,080 DELAYED INSULIN SECRETION, 1199 00:45:49,080 --> 00:45:51,720 HIGHER BLOOD PRESSURE, WORSE 1200 00:45:51,720 --> 00:45:53,760 POSTPRANDIAL LIPID LEVELS. 1201 00:45:53,760 --> 00:45:59,920 WE ALL HAVE AN INTERNAL 1202 00:45:59,920 --> 00:46:03,560 BIOLOGICAL CLOCK THIS SYSTEM 1203 00:46:03,560 --> 00:46:05,080 PRODUCES 24 HOUR RHYTHMS, 1204 00:46:05,080 --> 00:46:06,280 METABOLISM, PHYSIOLOGY, 1205 00:46:06,280 --> 00:46:06,560 BEHAVIOR. 1206 00:46:06,560 --> 00:46:07,520 YOUR GREATEST MUSCULAR STRENGTH 1207 00:46:07,520 --> 00:46:11,520 AND BEST COORDINATION ARE IN THE 1208 00:46:11,520 --> 00:46:12,040 AFTERNOON. 1209 00:46:12,040 --> 00:46:14,760 BODY REALLY STARTS TO PRODUCE 1210 00:46:14,760 --> 00:46:17,480 SLEEP HORMONE MELATONIN AT 1211 00:46:17,480 --> 00:46:19,000 NIGHT, GREATEST ALERTNESS IS IN 1212 00:46:19,000 --> 00:46:20,040 THE MORNING. 1213 00:46:20,040 --> 00:46:22,160 ACTUALLY TURNS OUT A NUMBER EVER 1214 00:46:22,160 --> 00:46:24,280 METABOLIC RHYTHMS SEEM TO FAVOR 1215 00:46:24,280 --> 00:46:25,920 THE MORNING OPTIMAL FOR 1216 00:46:25,920 --> 00:46:26,400 METABOLISM. 1217 00:46:26,400 --> 00:46:27,880 FOR INSTANCE, IN MOST PEOPLE 1218 00:46:27,880 --> 00:46:29,840 WITH EXCEPTION OF SHIFT WORKERS 1219 00:46:29,840 --> 00:46:33,680 AND THOSE WITH TYPE 2 DIABETES, 1220 00:46:33,680 --> 00:46:34,560 IT APPEARS BLOOD SUGAR CONTROL 1221 00:46:34,560 --> 00:46:37,200 IS BEST IN THE MORNING. 1222 00:46:37,200 --> 00:46:39,000 WE'VE KNOWN THIS FOR 50 YEARS 1223 00:46:39,000 --> 00:46:42,640 NOW, BUT WE DIDN'T KNOW ENOUGH 1224 00:46:42,640 --> 00:46:43,840 ABOUT THE CIRCADIAN TO KNOW WHAT 1225 00:46:43,840 --> 00:46:45,160 WAS DRIVING THEM. 1226 00:46:45,160 --> 00:46:46,600 IF YOU ADMINISTER ORAL GLUCOSE 1227 00:46:46,600 --> 00:46:49,680 TOLERANCE TEST IN THE MORNING, 1228 00:46:49,680 --> 00:46:50,680 AFTERNOON, EVENING, DESPITE 1229 00:46:50,680 --> 00:46:54,120 GIVING PEOPLE THE SAME AMOUNT OF 1230 00:46:54,120 --> 00:46:56,440 SUGAR TO CONSUME, LEVELS SPIKE 1231 00:46:56,440 --> 00:46:58,520 SIGNIFICANTLY HIGHER IN THE 1232 00:46:58,520 --> 00:47:00,360 MORNING AND AFTERNOON, NOT SMALL 1233 00:47:00,360 --> 00:47:03,360 EFFECTS, QUITE A HUGE EFFECT, A 1234 00:47:03,360 --> 00:47:05,080 40-POINT DIFFERENCE AT THE 1235 00:47:05,080 --> 00:47:06,600 TWO-HOUR MARK. 1236 00:47:06,600 --> 00:47:09,440 AND IT'S EQUIVALENT TO BASED ON 1237 00:47:09,440 --> 00:47:10,640 DEFINITIONS OF PREDIABETES BACK 1238 00:47:10,640 --> 00:47:14,720 WHEN TESTS WERE FIRST DEVELOPED, 1239 00:47:14,720 --> 00:47:15,600 EQUIVALENT TO BORDERLINE 1240 00:47:15,600 --> 00:47:23,600 PRE-DIABETIC IN AFTERNOON. 1241 00:47:23,600 --> 00:47:26,440 RHYTHMS SUGGEST MORNING IS 1242 00:47:26,440 --> 00:47:27,880 FAVORED, OPTIMAL FOR EATING. 1243 00:47:27,880 --> 00:47:30,160 THERMIC EFFECT OF FOOD, HOW MANY 1244 00:47:30,160 --> 00:47:32,560 CALORIES YOU BURN WHEN YOU 1245 00:47:32,560 --> 00:47:34,480 ABSORB AND DIGEST FOOD IS HIGHER 1246 00:47:34,480 --> 00:47:40,920 WHEN YOU EAT IN THE MORNING THAN 1247 00:47:40,920 --> 00:47:41,520 AFTERNOON. 1248 00:47:41,520 --> 00:47:43,000 MORE STUDIES REPORT INCREASE IN 1249 00:47:43,000 --> 00:47:44,760 THERMIC EFFECT OF FOOD IN THE 1250 00:47:44,760 --> 00:47:45,080 MORNING. 1251 00:47:45,080 --> 00:47:47,160 ALSO WE NOW HAVE THREE VERY 1252 00:47:47,160 --> 00:47:49,800 ELEGANT STUDIES DONE IN 1253 00:47:49,800 --> 00:47:51,080 METABOLIC CHAMBERS SHOWING WHEN 1254 00:47:51,080 --> 00:47:52,960 PEOPLE EAT EARLIER IN THE DAY 1255 00:47:52,960 --> 00:47:55,880 THEY ACTUALLY BURN MORE FAT, AND 1256 00:47:55,880 --> 00:47:56,760 THAT EXTRA FAT BURNING IS 1257 00:47:56,760 --> 00:47:58,080 ACTUALLY AT NIGHT. 1258 00:47:58,080 --> 00:47:59,920 WE HAVE NICE DATA REPLICATED 1259 00:47:59,920 --> 00:48:01,480 SHOWING GREATER FAT BURNING WITH 1260 00:48:01,480 --> 00:48:02,920 EATING EARLIER IN THE DAY. 1261 00:48:02,920 --> 00:48:07,720 THERE ARE ALSO SOME RHYTHMS IN 1262 00:48:07,720 --> 00:48:08,480 CARDIOVASCULAR ENDPOINTS, LESS 1263 00:48:08,480 --> 00:48:09,360 WELL STUDIED. 1264 00:48:09,360 --> 00:48:11,480 I SHOULD SAY A LOT LESS WELL 1265 00:48:11,480 --> 00:48:12,160 STUDIED IN THE LITERATURE. 1266 00:48:12,160 --> 00:48:16,880 FOR INSTANCE WE KNOW THERE'S A 1267 00:48:16,880 --> 00:48:18,680 SMALL CIRCADIAN IN BLOOD 1268 00:48:18,680 --> 00:48:22,520 PRESSURE, 3 TO 5%, I DON'T 1269 00:48:22,520 --> 00:48:24,400 REMEMBER AMPLITUDE. 1270 00:48:24,400 --> 00:48:26,440 ALSO WHAT'S QUITE INTERESTING IF 1271 00:48:26,440 --> 00:48:31,040 YOU LOOK AT PLASMA METABOLITES 1272 00:48:31,040 --> 00:48:34,120 15% HAVE CIRCADIAN RHYTHMS, ALSO 1273 00:48:34,120 --> 00:48:40,040 80% ARE LIPID SPECIES. 1274 00:48:40,040 --> 00:48:41,760 MOST LIPID SPECIES MID-MORNING 1275 00:48:41,760 --> 00:48:43,640 TO NOONTIME BUT UNLIKE GLYCEMIC 1276 00:48:43,640 --> 00:48:44,800 CONTROL WITH DISTINCT PHENOTYPES 1277 00:48:44,800 --> 00:48:46,720 WHERE THE MAJORITY OF PEOPLE 1278 00:48:46,720 --> 00:48:49,320 HAVE OPTIMAL CONTROL IN THE MID 1279 00:48:49,320 --> 00:48:51,400 TO LATE MORNINGS, LIPID RHYTHMS 1280 00:48:51,400 --> 00:48:52,520 ARE VARIABLE. 1281 00:48:52,520 --> 00:48:54,480 SOME APPEAR TO HAVE NO RHYTHM, 1282 00:48:54,480 --> 00:48:56,680 TIME OF DAY THEY PEAK IS 1283 00:48:56,680 --> 00:48:58,840 VARIABLE, DON'T REALLY 1284 00:48:58,840 --> 00:49:00,280 UNDERSTAND THAT YET. 1285 00:49:00,280 --> 00:49:01,480 WHEN YOU THINK ABOUT CIRCADIAN 1286 00:49:01,480 --> 00:49:03,800 SYSTEM TO UNDERSTAND HOW MEAL 1287 00:49:03,800 --> 00:49:08,080 TIMING MIGHT INTERACT WITH THE 1288 00:49:08,080 --> 00:49:09,160 CIRCADIAN SYSTEM, WE BREAK DOWN 1289 00:49:09,160 --> 00:49:10,920 THE CIRCADIAN SYSTEM IN TWO 1290 00:49:10,920 --> 00:49:11,440 PARTS. 1291 00:49:11,440 --> 00:49:14,520 ONE IS CENTRAL OR MASTER CLOCK, 1292 00:49:14,520 --> 00:49:18,000 LOCATED IN THE SUPER CHIASMATIC 1293 00:49:18,000 --> 00:49:20,880 NUCLEUS OF THE HYPER THALAMUS, 1294 00:49:20,880 --> 00:49:24,680 TIME ZONE, PHASE IS THE TERM, 1295 00:49:24,680 --> 00:49:26,320 ONE IMPORTANT FACTOR IS TIME OF 1296 00:49:26,320 --> 00:49:28,280 DAY YOU GET BRIGHT LIGHT 1297 00:49:28,280 --> 00:49:28,560 EXPOSURE. 1298 00:49:28,560 --> 00:49:31,120 CONVERSELY WE HAVE A NUMBER OF 1299 00:49:31,120 --> 00:49:32,120 CLOCKS LOCATED IN EVERY ORGAN 1300 00:49:32,120 --> 00:49:35,080 AND TISSUE IN THE BODY, 1301 00:49:35,080 --> 00:49:40,880 PERIPHERAL CLOCKS. 1302 00:49:40,880 --> 00:49:43,160 AND TIME ZONE IS SET BY FACTORS, 1303 00:49:43,160 --> 00:49:45,800 ONE OF THE MOST IMPORTANT 1304 00:49:45,800 --> 00:49:47,320 ESPECIALLY FOR HIGHLY METABOLIC 1305 00:49:47,320 --> 00:49:49,720 ORGANS SUCH AS LIVER AND 1306 00:49:49,720 --> 00:49:52,480 PANCREAS SET BY THE TIME OF DAY 1307 00:49:52,480 --> 00:49:56,120 THAT WE EAT. 1308 00:49:56,120 --> 00:49:56,760 SAID ANOTHER WAY, SIMPLIFYING 1309 00:49:56,760 --> 00:49:59,600 THIS A LITTLE BIT TO A FAULT, TO 1310 00:49:59,600 --> 00:50:04,200 GIVE A BIG PICTURE, IF WE HAVE 1311 00:50:04,200 --> 00:50:09,480 2: 1312 00:50:09,480 --> 00:50:13,400 TWOCLOCK SYSTEMS, IF YOU'RE 1313 00:50:13,400 --> 00:50:15,560 EATING OUT OF SYNC WITH BRIGHT 1314 00:50:15,560 --> 00:50:17,120 LIGHT EXPOSURE, THEY ARE IN 1315 00:50:17,120 --> 00:50:19,880 DIFFERENT TIME ZONES AND GIVE 1316 00:50:19,880 --> 00:50:21,160 CONFLICTING SYMBOLS WHETHER TO 1317 00:50:21,160 --> 00:50:23,400 REV UP OR REV DOWN, THIS IS ONE 1318 00:50:23,400 --> 00:50:27,120 FORM OF WHAT WE CALL CIRCADIAN 1319 00:50:27,120 --> 00:50:28,520 MISALIGNMENT, LEADS TO 1320 00:50:28,520 --> 00:50:28,800 DYSFUNCTION. 1321 00:50:28,800 --> 00:50:30,360 REALLY NICE ANALOGY FOR THIS 1322 00:50:30,360 --> 00:50:32,440 CLOCK SYSTEM HERE WHICH HAS BEEN 1323 00:50:32,440 --> 00:50:34,200 USED, I DON'T KNOW WHO TO GIVE 1324 00:50:34,200 --> 00:50:37,200 CREDIT TO FOR THIS ANALOGY, BUT 1325 00:50:37,200 --> 00:50:41,880 THINK OF THE CENTRAL CLOCK OF 1326 00:50:41,880 --> 00:50:44,400 CONDUCTOR OF ORCHESTRA, AND EACH 1327 00:50:44,400 --> 00:50:45,920 PERIPHERAL CLOCK IS A DIFFERENT 1328 00:50:45,920 --> 00:50:48,000 SECTION, IF YOU'RE TRYING TO 1329 00:50:48,000 --> 00:50:48,720 PLAY MUSIC, EVERYTHING IS 1330 00:50:48,720 --> 00:50:50,080 STARTING THEIR SECTION AT A 1331 00:50:50,080 --> 00:50:52,360 DIFFERENT POINT IN THE SCORE AND 1332 00:50:52,360 --> 00:50:55,480 SO YOU GET A CACOPHONY. 1333 00:50:55,480 --> 00:50:57,920 AND SOME OF THE FIRST REALLY 1334 00:50:57,920 --> 00:51:03,840 IMPORTANT DATA SHOWING CIRCADIAN 1335 00:51:03,840 --> 00:51:04,680 MISALIGNMENT WORSENS 1336 00:51:04,680 --> 00:51:05,880 CARDIOMETABOLIC HEALTH CAME FROM 1337 00:51:05,880 --> 00:51:08,400 FOLKS WHO DID THIS IMPORTANT 1338 00:51:08,400 --> 00:51:10,880 STUDY IN 2009, SHOWING IF YOU 1339 00:51:10,880 --> 00:51:13,360 TAKE HUMANS AND HAVE THEM EAT 1340 00:51:13,360 --> 00:51:15,160 ROUGHLY 12 HOURS OUT OF SYNC 1341 00:51:15,160 --> 00:51:17,880 WITH WHEN THEY HABITUALLY GET 1342 00:51:17,880 --> 00:51:20,280 BRIGHT LIGHT EXPOSURE, THAT THIS 1343 00:51:20,280 --> 00:51:20,960 CIRCADIAN MISALIGNMENT INCREASES 1344 00:51:20,960 --> 00:51:26,520 24 HOUR GLUCOSE LEVELS BY 6%, 24 1345 00:51:26,520 --> 00:51:28,760 HOUR INSULIN LEVELS BY 22%, SO 1346 00:51:28,760 --> 00:51:30,720 THIS KEEPS UP WITH THE THEME 1347 00:51:30,720 --> 00:51:32,120 BOTH IN INTERMITTENT FASTING AND 1348 00:51:32,120 --> 00:51:33,840 CIRCADIAN RESEARCH WHERE WE TEND 1349 00:51:33,840 --> 00:51:35,400 TO SEE MORE NEGATIVE CHANGES IN 1350 00:51:35,400 --> 00:51:37,000 INSULIN BEFORE WE SEE BIG 1351 00:51:37,000 --> 00:51:38,240 CHANGES IN GLUCOSE. 1352 00:51:38,240 --> 00:51:41,080 WE ALSO FIND NO WORSENING OF 1353 00:51:41,080 --> 00:51:43,720 MEAN ARTERIAL BLOOD PRESSURE, BY 1354 00:51:43,720 --> 00:51:47,760 3%, QUITE HUGE DECREASES IN 1355 00:51:47,760 --> 00:51:49,520 SLEEP EFFICIENCY BY 20%. 1356 00:51:49,520 --> 00:51:51,160 SO THEN YOU MIGHT HEAR THAT DATA 1357 00:51:51,160 --> 00:51:53,240 AND SAY GREAT, I WON'T EAT WHEN 1358 00:51:53,240 --> 00:51:55,440 IT'S DARK OUTSIDE OR LATER AT 1359 00:51:55,440 --> 00:51:55,640 NIGHT. 1360 00:51:55,640 --> 00:51:57,400 BUT THERE'S DATA ALSO SUGGESTING 1361 00:51:57,400 --> 00:52:00,240 THAT THE TIME OF DAY EVEN DURING 1362 00:52:00,240 --> 00:52:06,160 DAYLIGHT HOURS THAT YOU EAT 1363 00:52:06,160 --> 00:52:06,360 MATTERS. 1364 00:52:06,360 --> 00:52:09,880 IN ISRAEL THEY DID A HALF DOZEN 1365 00:52:09,880 --> 00:52:11,760 REALLY IMPORTANT STUDIES ON THIS 1366 00:52:11,760 --> 00:52:13,600 CONCEPT EATING BREAKFAST LIKE A 1367 00:52:13,600 --> 00:52:15,160 KING, LUNCH LIKE A PRINCE, 1368 00:52:15,160 --> 00:52:16,560 DINNER LIKE A PAUPER. 1369 00:52:16,560 --> 00:52:19,080 ONE OF THE MOST IMPORTANT FIRST 1370 00:52:19,080 --> 00:52:23,240 STUDIES IN 2013 IS THEY TOOK 93 1371 00:52:23,240 --> 00:52:24,680 WOMEN OVERWEIGHT, ENROLLED THEM 1372 00:52:24,680 --> 00:52:27,640 IN A 12 WEEK LONG TRIAL TO EAT A 1373 00:52:27,640 --> 00:52:29,040 LARGE BREAKFAST AND SMALL DINNER 1374 00:52:29,040 --> 00:52:32,560 OTHER SMALL BREAKFAST AND LARGE 1375 00:52:32,560 --> 00:52:32,800 DINNER. 1376 00:52:32,800 --> 00:52:35,680 COUNSELED TO EAT THE SAME NUMBER 1377 00:52:35,680 --> 00:52:39,320 OF CALORIES. 1378 00:52:39,320 --> 00:52:41,600 A LARGE BREAKFAST LOST MORE 1379 00:52:41,600 --> 00:52:44,120 WEIGHT OVER 12 WEEKS, AND THEY 1380 00:52:44,120 --> 00:52:45,320 WERE LESS HUNGRY THROUGHOUT THE 1381 00:52:45,320 --> 00:52:45,560 DAY. 1382 00:52:45,560 --> 00:52:48,480 I LIKE TO LOOK AT THIS FROM THE 1383 00:52:48,480 --> 00:52:49,240 FLIP SIDE. 1384 00:52:49,240 --> 00:52:51,440 FOR ME IT'S THE GROUP THAT'S 1385 00:52:51,440 --> 00:52:53,320 REALLY EATING LATE IN THE DAY 1386 00:52:53,320 --> 00:52:55,280 GETTING THE ONE/TWO PUNCH, 1387 00:52:55,280 --> 00:52:56,920 STRUGGLING TO LOSE WEIGHT BUT 1388 00:52:56,920 --> 00:52:57,920 DESPITE LOSING LESS WEIGHT THEY 1389 00:52:57,920 --> 00:52:59,440 ARE MORE HUNGRY THAN THE GROUP 1390 00:52:59,440 --> 00:53:02,600 THAT'S MORE SUCCESSFUL AT LOSING 1391 00:53:02,600 --> 00:53:03,200 WEIGHT. 1392 00:53:03,200 --> 00:53:03,840 THAT'S UNFORTUNATE. 1393 00:53:03,840 --> 00:53:05,480 AND THAT GROUP HAS DONE REALLY 1394 00:53:05,480 --> 00:53:07,120 IMPORTANT WORK TO SHOW SOME OF 1395 00:53:07,120 --> 00:53:09,160 THESE BENEFITS AGAIN ARE 1396 00:53:09,160 --> 00:53:11,920 INDEPENDENT OF FOOD OR CALORIE 1397 00:53:11,920 --> 00:53:12,160 INTAKE. 1398 00:53:12,160 --> 00:53:14,360 THEIR IS DATA FROM A ONE-WEEK 1399 00:53:14,360 --> 00:53:15,160 CROSSOVER CONTROLLED FEEDING 1400 00:53:15,160 --> 00:53:16,840 STUDY THEY DID. 1401 00:53:16,840 --> 00:53:18,720 THEY TRIED THE EXACT SAME ON TWO 1402 00:53:18,720 --> 00:53:19,880 EATING SCHEDULES. 1403 00:53:19,880 --> 00:53:22,840 AND THEY TOOK 18 ADULTS WITH 1404 00:53:22,840 --> 00:53:24,640 TYPE 2 DIABETES, EACH PATIENT 1405 00:53:24,640 --> 00:53:26,680 TRIED TWO EATING SCHEDULES. 1406 00:53:26,680 --> 00:53:27,920 AGAIN, REALLY FASCINATINGLY THEY 1407 00:53:27,920 --> 00:53:35,880 FOUND WHEN THEY MEASURED 1408 00:53:35,880 --> 00:53:37,880 GLUCOSE, LOWER LEVELS WITH A 1409 00:53:37,880 --> 00:53:38,880 LARGE BREAKFAST AND SMALL 1410 00:53:38,880 --> 00:53:39,520 DINNER. 1411 00:53:39,520 --> 00:53:43,240 AS WELL AS GREATER INSULIN 1412 00:53:43,240 --> 00:53:43,760 SECRETION. 1413 00:53:43,760 --> 00:53:44,760 TYPE 2 DIABETES, EXTRA SECRETION 1414 00:53:44,760 --> 00:53:45,960 IS A GOOD THING. 1415 00:53:45,960 --> 00:53:47,360 AFTER A SINGLE WEEK OF CHANGING 1416 00:53:47,360 --> 00:53:53,000 MEAL TIMES THEY WERE ABLE TO 1417 00:53:53,000 --> 00:53:53,520 IMPROVE INSULIN SECRETION, 1418 00:53:53,520 --> 00:53:55,160 ROUGHLY 15 TO 20% INCREASE AFTER 1419 00:53:55,160 --> 00:53:58,240 ONE WEEK OF CHANGING THE TIMING 1420 00:53:58,240 --> 00:53:59,520 OF MEALS, QUITE MATERIAL. 1421 00:53:59,520 --> 00:54:01,720 AND WE'RE STARTING TO SEE NOW 1422 00:54:01,720 --> 00:54:03,040 STUDIES ANSWERING THE QUESTION 1423 00:54:03,040 --> 00:54:05,320 OF WHETHER EARLY TIME RESTRICTED 1424 00:54:05,320 --> 00:54:09,600 EATING MAY BE MORE EFFICACIOUS, 1425 00:54:09,600 --> 00:54:11,360 SO WHETHER IT HAS -- IF YOU 1426 00:54:11,360 --> 00:54:12,920 STICK WITH THE PROGRAM 1427 00:54:12,920 --> 00:54:14,760 PERFECTLY, WHETHER IT HAS MORE 1428 00:54:14,760 --> 00:54:16,400 BENEFITS THAN TIME RESTRICTED 1429 00:54:16,400 --> 00:54:17,800 EATING BY SKIPPING BREAKFAST AND 1430 00:54:17,800 --> 00:54:20,440 EATING IN THE MIDDLE OF THE DAY. 1431 00:54:20,440 --> 00:54:25,480 AFTER SIX OR SEVEN STUDIES ON 1432 00:54:25,480 --> 00:54:26,920 THIS NOW, MODERATE SIZE STUDY 1433 00:54:26,920 --> 00:54:28,680 GIVES US BETTER CONFIDENCE IN 1434 00:54:28,680 --> 00:54:30,440 RESULTS, QUITE INTERESTING ALL 1435 00:54:30,440 --> 00:54:32,400 THREE OF THOSE MODERATE SIZE 1436 00:54:32,400 --> 00:54:34,440 STUDIES ARE THE ONES WITH LARGER 1437 00:54:34,440 --> 00:54:37,760 SAMPLE SIZE DO CONSISTENTLY 1438 00:54:37,760 --> 00:54:39,280 REPORT MORE CARDIOMETABOLIC 1439 00:54:39,280 --> 00:54:41,040 BENEFITS TO EARLY TIME RESTRICT 1440 00:54:41,040 --> 00:54:43,320 THE EATING, THEY JUST REPORT 1441 00:54:43,320 --> 00:54:44,120 MORE BENEFITS. 1442 00:54:44,120 --> 00:54:46,840 HERE IS A BEAUTIFUL GRAPHIC FROM 1443 00:54:46,840 --> 00:54:49,760 ONE WHERE THEY FOUND 1444 00:54:49,760 --> 00:54:50,640 STATISTICALLY SIMILAR WEIGHT 1445 00:54:50,640 --> 00:54:53,480 LOSS BUT GREATER IMPROVEMENT IN 1446 00:54:53,480 --> 00:54:56,880 BLOOD PRESSURE, GLYCEMIC 1447 00:54:56,880 --> 00:54:58,560 ENDPOINTS, LEPTIN, HUNGER. 1448 00:54:58,560 --> 00:54:59,960 WHERE DOING TIME RESTRICTED 1449 00:54:59,960 --> 00:55:05,840 EATING BY SKIPPING BRECK FAST 1450 00:55:05,840 --> 00:55:10,280 GOT IMPROVEMENT IN LEPTIN 1451 00:55:10,280 --> 00:55:10,520 LEVELS. 1452 00:55:10,520 --> 00:55:11,360 INTERMITTENT FASTING IMPROVES 1453 00:55:11,360 --> 00:55:14,040 HEALTH AND INCREASES LIFESPAN IN 1454 00:55:14,040 --> 00:55:14,400 ANIMALS. 1455 00:55:14,400 --> 00:55:16,680 IN OF IN HUMANS INTERVENTIONS 1456 00:55:16,680 --> 00:55:17,240 ARE HETEROGENEOUS. 1457 00:55:17,240 --> 00:55:20,080 WE NEED TO CONSIDER EACH TYPE 1458 00:55:20,080 --> 00:55:23,560 SEPARATELY IN TERMS OF ADHERENCE 1459 00:55:23,560 --> 00:55:25,360 AND BIOLOGICAL EFFECT. 1460 00:55:25,360 --> 00:55:26,560 ALSO DEMONSTRATED SOME POINT OF 1461 00:55:26,560 --> 00:55:27,560 INTERMITTENT FASTING ADHERENCE 1462 00:55:27,560 --> 00:55:28,840 IS A MAJOR CHALLENGE. 1463 00:55:28,840 --> 00:55:32,200 I DON'T SEE THOSE READILY 1464 00:55:32,200 --> 00:55:33,320 TRANSLATING INTO PUBLIC HEALTH 1465 00:55:33,320 --> 00:55:34,400 RECOMMENDATIONS SO THAT'S REALLY 1466 00:55:34,400 --> 00:55:37,480 IMPORTANT FOR US TO ACKNOWLEDGE. 1467 00:55:37,480 --> 00:55:39,240 THE THINK THE DATA IS CLEAR 1468 00:55:39,240 --> 00:55:40,640 INTERMITTENT FASTING INDUCES 1469 00:55:40,640 --> 00:55:42,480 WEIGHT LOSS AND IMPROVES 1470 00:55:42,480 --> 00:55:43,080 CARDIOMETABOLIC HEALTH. 1471 00:55:43,080 --> 00:55:45,480 THOUGH I ALSO THINK MOST OF THE 1472 00:55:45,480 --> 00:55:46,680 EVIDENCE SUGGESTS THAT FOR AT 1473 00:55:46,680 --> 00:55:51,560 LEAST MOST TYPES MAJORITY OF 1474 00:55:51,560 --> 00:55:54,240 BENEFITS, I DON'T THINK WE KNOW 1475 00:55:54,240 --> 00:55:55,440 ABOUT ALL BENEFITS LIKELY 1476 00:55:55,440 --> 00:55:56,560 DERIVED FROM ENERGY RESTRICTION, 1477 00:55:56,560 --> 00:55:57,440 THAT'S THE MOST IMPORTANT 1478 00:55:57,440 --> 00:56:00,800 MECHANISM AT LEAST FOR MANY OF 1479 00:56:00,800 --> 00:56:04,840 THESE TYPES OF INTERMITTENT 1480 00:56:04,840 --> 00:56:05,720 FASTING. 1481 00:56:05,720 --> 00:56:07,920 FOR TIME RESTRICTED EATING BASED 1482 00:56:07,920 --> 00:56:10,240 ON LAST THREE META-ANALYSES WE 1483 00:56:10,240 --> 00:56:12,240 CAN SAY TIME RESTRICTED EATING 1484 00:56:12,240 --> 00:56:13,920 APPEARS TO REDUCE BODY WEIGHT 1485 00:56:13,920 --> 00:56:16,080 MODERATELY COMPARED TO TYPICAL 1486 00:56:16,080 --> 00:56:17,320 PATTERNS AROUND TIME RESTRICT 1487 00:56:17,320 --> 00:56:22,720 THE EATING CAN HAVE BENEFITS 1488 00:56:22,720 --> 00:56:24,560 INDEPENDENT OF WEIGHT LOSS, WE 1489 00:56:24,560 --> 00:56:26,560 NEED MORE RESEARCH FOR THE 1490 00:56:26,560 --> 00:56:27,200 MULTI-MILLION DOLLAR QUESTION, 1491 00:56:27,200 --> 00:56:31,120 HOW MUCH OF THE EFFECTS OF THESE 1492 00:56:31,120 --> 00:56:32,640 INTERMITTENT FASTING ARE DUE TO 1493 00:56:32,640 --> 00:56:33,840 ENERGY RESTRICTION VERSUS TIME 1494 00:56:33,840 --> 00:56:35,320 OF DAY VERSUS EXTENDING FASTING. 1495 00:56:35,320 --> 00:56:38,800 WE MIGHT GO IN A DIFFERENT 1496 00:56:38,800 --> 00:56:42,240 PUBLIC HEALTH DIRECTION IF TIME 1497 00:56:42,240 --> 00:56:45,000 OF DAY IS MORE IMPORTANT. 1498 00:56:45,000 --> 00:56:46,960 WE NEED HIGHER QUALITY STUDIES 1499 00:56:46,960 --> 00:56:48,400 WITH LARGER SAMPLE SIZES. 1500 00:56:48,400 --> 00:56:49,840 WE HAVE MIXED RESULTS IN THE 1501 00:56:49,840 --> 00:56:50,160 FIELD. 1502 00:56:50,160 --> 00:56:51,320 PART IS BECAUSE LOTS OF PEOPLE 1503 00:56:51,320 --> 00:56:53,440 ARE DOING SMALL PILOT STUDIES 1504 00:56:53,440 --> 00:56:57,120 BUT WE NEED TO GET TO THE POINT 1505 00:56:57,120 --> 00:56:59,320 WE'RE DOING LARGER HIGHER 1506 00:56:59,320 --> 00:57:00,120 QUALITY STUDIES. 1507 00:57:00,120 --> 00:57:02,600 I'D LIKE TO THANK OUR SPONSORS 1508 00:57:02,600 --> 00:57:04,920 AND GRANT SUPPORT, ESPECIALLY 1509 00:57:04,920 --> 00:57:05,880 NIH, ALSO DEPARTMENT OF DEFENSE 1510 00:57:05,880 --> 00:57:07,960 OVER THE YEARS, AND TO THANK 1511 00:57:07,960 --> 00:57:11,160 EVERYONE IN MY LAB WHO MADE 1512 00:57:11,160 --> 00:57:12,560 THESE RESULTS POSSIBLE AND OUR 1513 00:57:12,560 --> 00:57:14,640 COLLABORATORS. 1514 00:57:14,640 --> 00:57:19,360 THANK YOU SO MUCH. 1515 00:57:19,360 --> 00:57:22,680 >> THANK YOU SO MUCH, DR. 1516 00:57:22,680 --> 00:57:23,560 PETERSON. 1517 00:57:23,560 --> 00:57:25,160 JUST SOME QUICK HOUSEKEEPING 1518 00:57:25,160 --> 00:57:28,480 NOTES BEFORE WE MOVE TO 1519 00:57:28,480 --> 00:57:29,320 QUESTIONS, MORE HOUSEKEEPING 1520 00:57:29,320 --> 00:57:29,760 NOTES. 1521 00:57:29,760 --> 00:57:33,240 I WANT TO HIGHLIGHT A FEW 1522 00:57:33,240 --> 00:57:34,120 RELATED OPPORTUNITIES. 1523 00:57:34,120 --> 00:57:37,920 FIRST, THE OFFICE OF NUTRITION 1524 00:57:37,920 --> 00:57:42,160 RESEARCH IF WE IS ADVANCE THE 1525 00:57:42,160 --> 00:57:47,040 SLIDES TO THIS NOTICE, NEXT 1526 00:57:47,040 --> 00:57:48,840 PLEASE. 1527 00:57:48,840 --> 00:57:49,600 ONE MORE. 1528 00:57:49,600 --> 00:57:51,320 IT MIGHT NOT BE IN THERE. 1529 00:57:51,320 --> 00:57:53,440 WELL, THE OFFICE OF NUTRITION 1530 00:57:53,440 --> 00:57:56,400 RESEARCH HAS RELEASED AN 1531 00:57:56,400 --> 00:57:57,560 INTERAGENCY REQUEST FOR 1532 00:57:57,560 --> 00:58:03,600 INFORMATION ON FOOD AS MEDICINE 1533 00:58:03,600 --> 00:58:07,360 RESEARCH. 1534 00:58:07,360 --> 00:58:10,760 SEARCH THIS NOTICE, NOT-OD-23 - 1535 00:58:10,760 --> 00:58:12,760 107, YOU'LL BE ABLE TO FIND THIS 1536 00:58:12,760 --> 00:58:15,240 REQUEST FOR INFORMATION AND 1537 00:58:15,240 --> 00:58:18,400 OFFER INPUT ON RESEARCH, 1538 00:58:18,400 --> 00:58:20,040 OPPORTUNITIES FOR COMMUNITY 1539 00:58:20,040 --> 00:58:21,360 ENGAGEMENT, AND OTHER ITEMS THAT 1540 00:58:21,360 --> 00:58:24,640 THE OFFICE OF NUTRITION RESEARCH 1541 00:58:24,640 --> 00:58:25,640 IS LOOKING FOR. 1542 00:58:25,640 --> 00:58:27,480 IF YOU FOUND THIS TOPIC 1543 00:58:27,480 --> 00:58:30,000 INTERESTING, AND WOULD LIKE TO 1544 00:58:30,000 --> 00:58:33,640 LEARN MORE, PLEASE REGISTER FOR 1545 00:58:33,640 --> 00:58:35,120 AN UPCOMING NHLBI ON NUTRITION 1546 00:58:35,120 --> 00:58:38,960 ON MAY 2 AND MAY 3 WHERE A 1547 00:58:38,960 --> 00:58:40,960 MULTI-DISCIPLINARY GROUP OF 1548 00:58:40,960 --> 00:58:42,920 INVESTIGATORS INCLUDING DR. 1549 00:58:42,920 --> 00:58:46,000 PETERSON WILL HIGHLIGHT EMERGING 1550 00:58:46,000 --> 00:58:49,200 RESEARCH LINKING CIRCADIAN CLOCK 1551 00:58:49,200 --> 00:58:50,280 TO NUTRITION-RELATED DISEASE 1552 00:58:50,280 --> 00:58:52,200 RISK, PATHOPHYSIOLOGY, AND 1553 00:58:52,200 --> 00:58:52,600 INTERVENTION. 1554 00:58:52,600 --> 00:58:56,080 YOU CAN REGISTER FOR THIS BY 1555 00:58:56,080 --> 00:58:59,240 SEARCHING NHLBI'S PUBLIC WEBSITE 1556 00:58:59,240 --> 00:58:59,920 UNDER EVENTS. 1557 00:58:59,920 --> 00:59:02,200 I'LL GET TO QUESTIONS NOW 1558 00:59:02,200 --> 00:59:04,400 BECAUSE WE HAD AMAZING QUESTIONS 1559 00:59:04,400 --> 00:59:05,720 COMING IN FROM OUR AUDIENCE 1560 00:59:05,720 --> 00:59:06,400 TODAY. 1561 00:59:06,400 --> 00:59:14,160 I'M GOING TO ROLL A FEW INTO 1562 00:59:14,160 --> 00:59:14,560 ONE. 1563 00:59:14,560 --> 00:59:16,960 THE DATA ON BREAKFAST TIMING AND 1564 00:59:16,960 --> 00:59:20,040 SKIPPING BREAKFAST WAS PRETTY 1565 00:59:20,040 --> 00:59:20,360 EXCITING. 1566 00:59:20,360 --> 00:59:23,120 BOTTOM LINE IS DON'T MISS 1567 00:59:23,120 --> 00:59:23,480 BREAKFAST. 1568 00:59:23,480 --> 00:59:28,920 BUT IT OPENS UP QUESTIONING TO A 1569 00:59:28,920 --> 00:59:30,800 LARGER TIMING-RELATED ISSUE. 1570 00:59:30,800 --> 00:59:32,440 SHOULD BREAKFAST -- SHOULD MEALS 1571 00:59:32,440 --> 00:59:34,920 IN GENERAL BUT SPECIFICALLY 1572 00:59:34,920 --> 00:59:36,160 BREAKFAST GIVEN ITS IMPORTANCE 1573 00:59:36,160 --> 00:59:37,240 BASED ON DATA, HAPPEN AT THE 1574 00:59:37,240 --> 00:59:38,080 SAME TIME? 1575 00:59:38,080 --> 00:59:39,760 WHAT WOULD BE THE OPTIMUM TIME 1576 00:59:39,760 --> 00:59:43,720 FOR BREAKFAST MEALS OR DAYTIME 1577 00:59:43,720 --> 00:59:44,040 MEALS? 1578 00:59:44,040 --> 00:59:46,560 AND SHOULD FASTING OR YOUR 1579 00:59:46,560 --> 00:59:47,160 TIME-RESTRICTED EATING TAKE 1580 00:59:47,160 --> 00:59:48,760 PLACE AT THE SAME TIME? 1581 00:59:48,760 --> 00:59:51,680 SHOULD THE ENERGY BALANCE THERE, 1582 00:59:51,680 --> 00:59:52,760 INTAKE BALANCE THERE, OCCUR AT 1583 00:59:52,760 --> 00:59:55,520 THE SAME TIMES EVERY DAY? 1584 00:59:55,520 --> 00:59:56,400 >> GREAT QUESTION. 1585 00:59:56,400 --> 00:59:58,360 I'LL TAKE THE BREAKFAST SKIPPING 1586 00:59:58,360 --> 00:59:59,160 QUESTION FIRST. 1587 00:59:59,160 --> 01:00:00,040 BREAKFAST SKIPPING QUESTION 1588 01:00:00,040 --> 01:00:02,440 TENDS TO BE MUCH MORE NUANCED 1589 01:00:02,440 --> 01:00:03,840 THAN IS OBVIOUS. 1590 01:00:03,840 --> 01:00:07,040 SO IT'S REALLY INTERESTING, 1591 01:00:07,040 --> 01:00:08,680 RESEARCH OUT OF JAPAN PEOPLE 1592 01:00:08,680 --> 01:00:12,800 TEND TO SKIP IN TWO WAYS, IN 1593 01:00:12,800 --> 01:00:14,880 JAPAN HALF OF PEOPLE SKIP 1594 01:00:14,880 --> 01:00:17,840 BREAKFAST AND EAT DINNER AT 1595 01:00:17,840 --> 01:00:20,560 NORMAL TIME, PRACTICING 1596 01:00:20,560 --> 01:00:21,120 TIME-RESTRICTED EATING 1597 01:00:21,120 --> 01:00:21,440 TECHNICALLY. 1598 01:00:21,440 --> 01:00:22,760 IF YOU DO THAT BUT SKIP 1599 01:00:22,760 --> 01:00:24,640 BREAKFAST DO YOU STILL GET 1600 01:00:24,640 --> 01:00:26,720 BENEFITS OF THE PROLONGED DAILY 1601 01:00:26,720 --> 01:00:27,280 FASTING PERIOD? 1602 01:00:27,280 --> 01:00:33,200 I DON'T THINK WE FULLY KNOW THE 1603 01:00:33,200 --> 01:00:34,280 ANSWER YET. 1604 01:00:34,280 --> 01:00:36,040 SHORT TERM STUDIES WE HAVE WHERE 1605 01:00:36,040 --> 01:00:38,240 PEOPLE SKIP BREAKFAST UP TO A 1606 01:00:38,240 --> 01:00:40,960 WEEK, DATA HAS SHOWN THAT AT 1607 01:00:40,960 --> 01:00:42,480 LEAST GLUCOSE LEVELS ARE BETTER 1608 01:00:42,480 --> 01:00:46,120 WITH EATING THREE MEALS A DAY IF 1609 01:00:46,120 --> 01:00:49,520 DINNER IS AT A FIXED TIME THAN 1610 01:00:49,520 --> 01:00:54,960 SKIPPING BREAKFAST BUT MAY NOT 1611 01:00:54,960 --> 01:01:00,400 GIVE TIME TO TO ADAPT, THERE CD 1612 01:01:00,400 --> 01:01:01,760 BE BENEFITS FOR SUSTAINED PERIOD 1613 01:01:01,760 --> 01:01:02,400 OF TIME. 1614 01:01:02,400 --> 01:01:07,200 THE OTHER HALF OF FOLKS WHO SKIP 1615 01:01:07,200 --> 01:01:09,120 BREAKFAST, EAT DINNER LATE, THE 1616 01:01:09,120 --> 01:01:11,200 DATA ARE CONSISTENT THAT IF YOU 1617 01:01:11,200 --> 01:01:12,280 SKIP BREAKFAST AND EAT DINNER 1618 01:01:12,280 --> 01:01:13,600 LATE THERE ARE NEGATIVE 1619 01:01:13,600 --> 01:01:15,480 CONSEQUENCES BUT IT'S THE FIRST 1620 01:01:15,480 --> 01:01:16,480 BREAKFAST SKIPPING PHENOTYPE 1621 01:01:16,480 --> 01:01:17,680 THAT WE HAVE A LOT OF QUESTIONS 1622 01:01:17,680 --> 01:01:17,880 ABOUT. 1623 01:01:17,880 --> 01:01:19,400 IT'S A QUESTION OF THE TRADEOFF 1624 01:01:19,400 --> 01:01:23,000 BETWEEN TIME OF DAY AND 1625 01:01:23,000 --> 01:01:27,640 PROLONGED FASTING PERIOD. 1626 01:01:27,640 --> 01:01:28,760 SECOND QUESTION, CONSISTENCY, SO 1627 01:01:28,760 --> 01:01:30,800 THE RESEARCH WE HAVE IN 1628 01:01:30,800 --> 01:01:32,760 PRE-CLINICAL MODELS AND HUMAN 1629 01:01:32,760 --> 01:01:34,760 STUDIES REALLY SEEMS TO INDICATE 1630 01:01:34,760 --> 01:01:37,760 THAT A CONSISTENT START AND END 1631 01:01:37,760 --> 01:01:40,240 TIME IS REALLY IMPORTANT FOR 1632 01:01:40,240 --> 01:01:41,000 TIME-RESTRICTED EATING, YOU 1633 01:01:41,000 --> 01:01:42,280 CAN'T START AT 8:00 A.M. ONE 1634 01:01:42,280 --> 01:01:46,480 DAY, 12:00 P.M. THE NEXT DAY. 1635 01:01:46,480 --> 01:01:50,840 IT'S A FORM OF CIRCADIAN 1636 01:01:50,840 --> 01:01:52,080 MISALIGNMENT OR SHIFT IS 1637 01:01:52,080 --> 01:01:54,080 FREQUENTLY SHIFTING THE TIMING 1638 01:01:54,080 --> 01:01:56,720 OF THOSE PERIPHERAL CLOCKS. 1639 01:01:56,720 --> 01:01:58,520 AND SO AT LEAST WE BELIEVE 1640 01:01:58,520 --> 01:01:59,720 CONSISTENCY OF MEAL TIMES IS 1641 01:01:59,720 --> 01:02:00,280 IMPORTANT. 1642 01:02:00,280 --> 01:02:01,360 THERE ARE AT LEAST TWO HUMAN 1643 01:02:01,360 --> 01:02:03,560 STUDIES THAT DIDN'T COME FROM A 1644 01:02:03,560 --> 01:02:06,080 CHRONOBIOLOGY COMMUNITY BUT WITH 1645 01:02:06,080 --> 01:02:09,600 VERY CLEVER STUDY DESIGNS SHOWED 1646 01:02:09,600 --> 01:02:12,000 WORSE CARDIOMETABOLIC OUTCOMES 1647 01:02:12,000 --> 01:02:13,200 WITH IRREGULAR MEAL TIMING. 1648 01:02:13,200 --> 01:02:14,280 >> VERY INTERESTING. 1649 01:02:14,280 --> 01:02:19,760 GOOD TO KEEP IN MIND. 1650 01:02:19,760 --> 01:02:20,440 NEXT QUESTION OR QUESTIONS 1651 01:02:20,440 --> 01:02:23,640 ROLLED INTO ONE FOR THE BENEFIT 1652 01:02:23,640 --> 01:02:25,920 OF TIME ARE ON DIFFERENT 1653 01:02:25,920 --> 01:02:29,520 POPULATIONS WITHIN THE LARGER 1654 01:02:29,520 --> 01:02:31,040 POPULATION GROUPS. 1655 01:02:31,040 --> 01:02:32,720 SPECIFICALLY, WHEN WE THINK 1656 01:02:32,720 --> 01:02:35,120 ABOUT LIFESTYLE INTERVENTIONS OR 1657 01:02:35,120 --> 01:02:35,960 BEHAVIORAL INTERVENTIONS TO 1658 01:02:35,960 --> 01:02:38,160 BETTER OUR HEALTH OUTCOMES WE 1659 01:02:38,160 --> 01:02:43,840 HAVE TO CONSIDER EFFECTIVE AGE 1660 01:02:43,840 --> 01:02:46,160 AND THINGS LIKE SHIFT WORK, FOR 1661 01:02:46,160 --> 01:02:47,400 EXAMPLE, OR WORK SCHEDULES, LIFE 1662 01:02:47,400 --> 01:02:50,080 SCHEDULES, HOW THAT MAY IMPACT 1663 01:02:50,080 --> 01:02:51,960 OUR CIRCADIAN RHYTHMS AND MORE 1664 01:02:51,960 --> 01:02:55,240 SOCIAL BEHAVIORS, LIKE MEAL 1665 01:02:55,240 --> 01:02:56,120 TIMING, RIGHT? 1666 01:02:56,120 --> 01:02:57,200 YES, EATING IS BIOLOGICAL. 1667 01:02:57,200 --> 01:02:59,200 BUT WE ALSO TEND TO COME 1668 01:02:59,200 --> 01:03:00,720 TOGETHER OVER FOOD. 1669 01:03:00,720 --> 01:03:04,760 SO, WITH REGARD TO THESE SPECIAL 1670 01:03:04,760 --> 01:03:06,320 POPULATIONS, SHIFT WORK 1671 01:03:06,320 --> 01:03:08,520 POPULATIONS, EFFECTS OR IMPACTS 1672 01:03:08,520 --> 01:03:10,560 ACROSS THE LIFESPAN, WHAT KIND 1673 01:03:10,560 --> 01:03:12,760 OF CONSIDERATIONS DO YOU SUGGEST 1674 01:03:12,760 --> 01:03:17,320 OR DOES THE DATA INDICATE? 1675 01:03:17,320 --> 01:03:19,080 >> YEAH, GREAT QUESTION ABOUT 1676 01:03:19,080 --> 01:03:19,840 AGE-RELATED EFFECTS. 1677 01:03:19,840 --> 01:03:22,160 I WOULD SAY WE DON'T HAVE ANY 1678 01:03:22,160 --> 01:03:24,160 GOOD DATA IN HUMANS WHO THIS 1679 01:03:24,160 --> 01:03:24,440 QUESTION. 1680 01:03:24,440 --> 01:03:27,040 THERE HAVE BEEN A COUPLE STUDIES 1681 01:03:27,040 --> 01:03:29,640 IN OLDER ADULTS, ONE OF THEM I 1682 01:03:29,640 --> 01:03:33,240 WAS A CO-INVESTIGATOR ON, WE DID 1683 01:03:33,240 --> 01:03:34,320 FIND MODEST IMPROVEMENTS IN 1684 01:03:34,320 --> 01:03:37,280 CARDIO RESPIRATORY FITNESS IN 1685 01:03:37,280 --> 01:03:42,280 OLDER ADULTS. 1686 01:03:42,280 --> 01:03:45,160 BUT THEIR CIRCADIAN RESULTS ARE 1687 01:03:45,160 --> 01:03:46,040 DAMPENED OR ATTENUATED, DOES 1688 01:03:46,040 --> 01:03:47,880 THAT SUGGEST MORE OR LESS 1689 01:03:47,880 --> 01:03:51,720 BENEFITS WITH VARIOUS MEAL TIME 1690 01:03:51,720 --> 01:03:52,680 APPROACHES? 1691 01:03:52,680 --> 01:03:53,800 NO IDEA. 1692 01:03:53,800 --> 01:03:56,440 ANECDOTALLY WE DON'T SEE STRONG 1693 01:03:56,440 --> 01:03:58,280 AGE-DEPENDENT EFFECTS, BUT AGAIN 1694 01:03:58,280 --> 01:04:00,360 OUR SAMPLE SIZES AREN'T WELL 1695 01:04:00,360 --> 01:04:01,800 POWERED TO ANSWER THAT QUESTION. 1696 01:04:01,800 --> 01:04:05,480 WE DON'T SEE OBVIOUS EFFECTS FOR 1697 01:04:05,480 --> 01:04:07,240 INSTANCE WHERE OLDER ADULTS GET 1698 01:04:07,240 --> 01:04:08,560 FEWER BENEFITS BUT WE DON'T HAVE 1699 01:04:08,560 --> 01:04:09,240 ANY IDEA. 1700 01:04:09,240 --> 01:04:10,880 THERE'S INTERESTING WORK IN 1701 01:04:10,880 --> 01:04:14,320 ANIMALS ABOUT AGE OF ONSET OF 1702 01:04:14,320 --> 01:04:16,120 INTERMITTENT FASTING AND IN 1703 01:04:16,120 --> 01:04:17,880 JUVENILES IT SENDS TO STUNT THE 1704 01:04:17,880 --> 01:04:18,120 ANIMALS. 1705 01:04:18,120 --> 01:04:21,320 THAT'S A CONCERN. 1706 01:04:21,320 --> 01:04:24,760 I DON'T RECOMMEND INTERMITTENT 1707 01:04:24,760 --> 01:04:25,760 FASTING IN ADOLESCENCE, THERE'S 1708 01:04:25,760 --> 01:04:28,360 SOME STUDIES THAT SHOW YOU NEED 1709 01:04:28,360 --> 01:04:29,520 TO INITIATE TIME RESTRICTED 1710 01:04:29,520 --> 01:04:31,760 EATING EARLY ENOUGH IN LIFE TO 1711 01:04:31,760 --> 01:04:34,320 REALLY GET THOSE BENEFITS. 1712 01:04:34,320 --> 01:04:35,040 >> INTERESTING. 1713 01:04:35,040 --> 01:04:35,280 OKAY. 1714 01:04:35,280 --> 01:04:36,880 ONE OF THE OTHER THINGS THAT 1715 01:04:36,880 --> 01:04:39,000 STOOD OUT TO MY, AND ALSO STOOD 1716 01:04:39,000 --> 01:04:41,080 OUT TO SOME OTHER PEOPLE, THIS 1717 01:04:41,080 --> 01:04:43,800 RELATIONSHIP BETWEEN MEAL TIMING 1718 01:04:43,800 --> 01:04:44,920 AND SLEEP. 1719 01:04:44,920 --> 01:04:47,080 ALSO TYING INTO THAT THIS THIRD 1720 01:04:47,080 --> 01:04:50,280 PILLAR OF HEALTH, PHYSICAL 1721 01:04:50,280 --> 01:04:50,560 ACTIVITY. 1722 01:04:50,560 --> 01:04:51,880 DIET, PHYSICAL ACTIVITY, AND 1723 01:04:51,880 --> 01:04:53,640 SLEEP ARE THESE PILLARS OF 1724 01:04:53,640 --> 01:04:53,960 HEALTH. 1725 01:04:53,960 --> 01:04:56,040 HOW DO THEY INFORM EACH OTHER 1726 01:04:56,040 --> 01:04:59,320 AND WHEN YOU'RE DESIGNING 1727 01:04:59,320 --> 01:05:00,520 EXPERIMENTS OR CLINICAL STUDIES, 1728 01:05:00,520 --> 01:05:03,040 IS PHYSICAL ACTIVITY TAKEN INTO 1729 01:05:03,040 --> 01:05:05,680 ACCOUNT ALONG WITH SLEEP 1730 01:05:05,680 --> 01:05:08,040 BEHAVIORS, TO SORT OF SUPPORT OR 1731 01:05:08,040 --> 01:05:09,600 REINFORCE, OR WHAT ARE YOU 1732 01:05:09,600 --> 01:05:10,840 SEEING IN THE LITERATURE AND 1733 01:05:10,840 --> 01:05:12,400 RESEARCH THESE DAYS? 1734 01:05:12,400 --> 01:05:14,240 >> GREAT QUESTION. 1735 01:05:14,240 --> 01:05:16,160 I'LL TACKLE EACH SEPARATELY. 1736 01:05:16,160 --> 01:05:17,600 FOR SLEEP, MOST OF THE STUDIES 1737 01:05:17,600 --> 01:05:19,880 ON INTERMITTENT FASTING AND 1738 01:05:19,880 --> 01:05:21,960 SLEEP HAVE FOUND ABSOLUTELY NO 1739 01:05:21,960 --> 01:05:22,200 EFFECT. 1740 01:05:22,200 --> 01:05:24,000 I DON'T WANT TO SAY WE'RE AN 1741 01:05:24,000 --> 01:05:25,280 OUTLIER, ANOTHER GROUP HAS BEEN 1742 01:05:25,280 --> 01:05:28,560 ABLE TO REPLICATE OUR FINDINGS 1743 01:05:28,560 --> 01:05:29,640 BUT HAVEN'T PUBLISHED, SHORTER 1744 01:05:29,640 --> 01:05:31,600 SLEEP DURATION BUT GREATER 1745 01:05:31,600 --> 01:05:34,000 ENERGY LEVELS, LESS FATIGUE WITH 1746 01:05:34,000 --> 01:05:35,160 EARLY TIME RESTRICTED EATING, 1747 01:05:35,160 --> 01:05:37,760 EARLY EATING MAY BE KIND OF A 1748 01:05:37,760 --> 01:05:39,920 DIFFERENT BEAST. 1749 01:05:39,920 --> 01:05:41,880 MOST STUDIES DON'T FIND LARGE 1750 01:05:41,880 --> 01:05:44,000 EFFECTS ON SLEEP. 1751 01:05:44,000 --> 01:05:45,720 FOR PHYSICAL ACTIVITY, AGAIN 1752 01:05:45,720 --> 01:05:47,080 MOST STUDIES ON INTERMITTENT 1753 01:05:47,080 --> 01:05:49,120 FASTING FIND NEITHER POSITIVE 1754 01:05:49,120 --> 01:05:52,400 NOR NEGATIVE EFFECTS ON PHYSICAL 1755 01:05:52,400 --> 01:05:52,840 ACTIVITY. 1756 01:05:52,840 --> 01:05:54,720 CHRISTA VERDE AS LOOKED AT 1757 01:05:54,720 --> 01:05:56,720 TIMING OF PHYSICAL ACTIVITY AND 1758 01:05:56,720 --> 01:05:57,360 INTERACTION WITH FASTING. 1759 01:05:57,360 --> 01:06:01,400 I THINK IN THE CONTEXT OF 1760 01:06:01,400 --> 01:06:08,240 ALTERNATE DAY MODIFIED FASTING. 1761 01:06:08,240 --> 01:06:09,960 ON FOOD INTAKE MOST OF THE 1762 01:06:09,960 --> 01:06:12,480 STUDIES SUGGEST NO MAJOR CHANGES 1763 01:06:12,480 --> 01:06:14,880 IN DIET QUALITY, SO SOME 1764 01:06:14,880 --> 01:06:16,200 STUDIES -- MAYBE TWO STUDIES 1765 01:06:16,200 --> 01:06:17,960 SUGGESTED SOME PEOPLE ARE 1766 01:06:17,960 --> 01:06:20,680 CONSUMING LESS ALCOHOL WHICH 1767 01:06:20,680 --> 01:06:22,000 PERHAPS IS NOT SURPRISING, A 1768 01:06:22,000 --> 01:06:22,880 GOOD THING. 1769 01:06:22,880 --> 01:06:28,160 AND I THINK ONE STUDY FOUND LESS 1770 01:06:28,160 --> 01:06:29,280 CARBOHYDRATE INTAKE THAT WE 1771 01:06:29,280 --> 01:06:30,360 WEREN'T ABLE TO REPLICATE. 1772 01:06:30,360 --> 01:06:33,520 WE FIND PEOPLE JUST TAKE THE 1773 01:06:33,520 --> 01:06:35,480 SAME EATING HABITS AND CONDENSE 1774 01:06:35,480 --> 01:06:37,000 INTO A SHORTER EATING PERIOD AND 1775 01:06:37,000 --> 01:06:38,840 DON'T SEE CHANGES IN DIET 1776 01:06:38,840 --> 01:06:40,080 QUALITY, THEY SEEM TO BE 1777 01:06:40,080 --> 01:06:41,400 SEPARATE DOMAINS, THE MEAL 1778 01:06:41,400 --> 01:06:46,840 TIMING, VERSE U.S. -- VERSUS 1779 01:06:46,840 --> 01:06:47,240 DIET QUALITY. 1780 01:06:47,240 --> 01:06:48,400 >> THAT BRINGS UP ANOTHER 1781 01:06:48,400 --> 01:06:49,280 QUESTION THAT RESONATES WITH 1782 01:06:49,280 --> 01:06:49,680 Q&A. 1783 01:06:49,680 --> 01:06:52,000 A LOT OF STUDIES HAVE BEEN DONE 1784 01:06:52,000 --> 01:06:54,440 IN OVERWEIGHT OR OBESITY 1785 01:06:54,440 --> 01:06:55,400 POPULATIONS, RIGHT? 1786 01:06:55,400 --> 01:07:04,560 WHAT ARE THE EFFECTS OR THE 1787 01:07:04,560 --> 01:07:05,760 POTENTIAL EFFECTS OF 1788 01:07:05,760 --> 01:07:07,440 TIME-RESTRICTED EATING IN NORMAL 1789 01:07:07,440 --> 01:07:07,880 WEIGHT INDIVIDUALS? 1790 01:07:07,880 --> 01:07:09,920 >> GREAT QUESTION. 1791 01:07:09,920 --> 01:07:10,720 SLIGHTLY HARDER QUESTION BECAUSE 1792 01:07:10,720 --> 01:07:12,680 OF THE LEVEL OF NUANCE REQUIRED 1793 01:07:12,680 --> 01:07:15,200 TO ANSWER. 1794 01:07:15,200 --> 01:07:17,040 GENERALLY HEALTHY POPULATIONS 1795 01:07:17,040 --> 01:07:19,120 IT'S GENERALLY HARDER TO SEE 1796 01:07:19,120 --> 01:07:21,080 EFFECT BECAUSE THE BODY IS A 1797 01:07:21,080 --> 01:07:22,440 WONDERFUL HOMEO STAT, BLOOD 1798 01:07:22,440 --> 01:07:23,520 SUGAR IS PERFECT, IT'S NOT GOING 1799 01:07:23,520 --> 01:07:24,920 TO PUSH THAT LOWER. 1800 01:07:24,920 --> 01:07:27,440 I'M PART OF A STUDY FUNDED BY 1801 01:07:27,440 --> 01:07:31,080 THE NIA, SITE P.I., WE'RE 1802 01:07:31,080 --> 01:07:34,000 LOOKING AT HEALTHY INDIVIDUALS, 1803 01:07:34,000 --> 01:07:39,240 WHETHER THIS CAN SLOW BIOMARKERS 1804 01:07:39,240 --> 01:07:41,560 OF AGING, ENDPOINTS WITH STEM 1805 01:07:41,560 --> 01:07:42,520 CELL PRODUCTION, TELOMERE 1806 01:07:42,520 --> 01:07:45,080 LENGTH, MOLECULAR CHANGES. 1807 01:07:45,080 --> 01:07:50,880 MY LAB HAS FOUND CHANGES IN 1808 01:07:50,880 --> 01:07:55,360 AUTOPHAGY, MARKERS OF OXIDATEIVE 1809 01:07:55,360 --> 01:07:58,080 STRESSES, CERT 1 SIGNALING, A 1810 01:07:58,080 --> 01:07:59,960 GENE RELATED TO LONGEVITY. 1811 01:07:59,960 --> 01:08:07,320 WE DID FIND ALTERATIONS IN 1812 01:08:07,320 --> 01:08:08,440 CORTISOL PRODUCTION. 1813 01:08:08,440 --> 01:08:10,480 MY GUESS IS THESE WOULD 1814 01:08:10,480 --> 01:08:11,120 EXTRAPOLATE TO HEALTHY 1815 01:08:11,120 --> 01:08:14,400 POPULATIONS, THESE TYPE OF 1816 01:08:14,400 --> 01:08:14,640 EFFECTS. 1817 01:08:14,640 --> 01:08:15,520 >> VERY COOL. 1818 01:08:15,520 --> 01:08:17,920 THAT LEADS INTO A DIFFERENT 1819 01:08:17,920 --> 01:08:21,520 TOPIC OF AUTOPHAGY AND THEN ALSO 1820 01:08:21,520 --> 01:08:22,960 IMMUNE RESPONSIVENESS, RIGHT? 1821 01:08:22,960 --> 01:08:25,040 SO, IS THERE A LOT OF 1822 01:08:25,040 --> 01:08:27,960 INFORMATION ON HOW THESE DIETS 1823 01:08:27,960 --> 01:08:37,040 IMPACT IMMUNE RESPONSIVE 1824 01:08:37,040 --> 01:08:38,000 AUTOPHAGY, INFLAMMATION, 1825 01:08:38,000 --> 01:08:39,560 PHYSIOLOGIC SIGNALS THAT PREEMPT 1826 01:08:39,560 --> 01:08:41,120 BODY REPAIR? 1827 01:08:41,120 --> 01:08:42,200 >> IN HUMANS, NO. 1828 01:08:42,200 --> 01:08:44,960 IT'S HARD TO MEASURE IN HUMANS, 1829 01:08:44,960 --> 01:08:47,360 OTHER THAN TO MEASURE GENE 1830 01:08:47,360 --> 01:08:50,840 EXPRESSION, I THINK MY LAB MAY 1831 01:08:50,840 --> 01:08:55,120 BE ONE OTHER LAB HAS BEEN ONLY 1832 01:08:55,120 --> 01:08:56,520 ONE TO MEASURE AUTOPHAGY-RELATED 1833 01:08:56,520 --> 01:08:57,200 END POINTS. 1834 01:08:57,200 --> 01:08:58,240 ON IMMUNE SYSTEM FUNCTION THAT 1835 01:08:58,240 --> 01:08:59,200 DATA IS MIXED. 1836 01:08:59,200 --> 01:09:00,040 I CAN'T MAKE SENSE OF WHETHER 1837 01:09:00,040 --> 01:09:01,600 THERE SEEMS TO BE A TREND 1838 01:09:01,600 --> 01:09:05,480 TOWARDS NULL OR POSITIVE 1839 01:09:05,480 --> 01:09:06,000 FINDINGS. 1840 01:09:06,000 --> 01:09:07,920 IN ANIMALS, THERE'S BEEN SOME 1841 01:09:07,920 --> 01:09:09,560 REALLY FASCINATING WORK THAT'S 1842 01:09:09,560 --> 01:09:13,360 COME LARGELY FROM THE COMMUNITY 1843 01:09:13,360 --> 01:09:15,360 OF CANCER RESEARCHERS THAT SHOW 1844 01:09:15,360 --> 01:09:17,160 SHIFT IN T CELL POPULATIONS, 1845 01:09:17,160 --> 01:09:20,080 RESPONSE TO INTERMITTENT FASTING 1846 01:09:20,080 --> 01:09:21,720 PARTICULARLY FASTING MIMICKING 1847 01:09:21,720 --> 01:09:25,000 DIET THAT FAVOR ANTITUMOR 1848 01:09:25,000 --> 01:09:25,240 IMMUNITY. 1849 01:09:25,240 --> 01:09:27,160 SO I'M NOT AN EXPERT IN THIS 1850 01:09:27,160 --> 01:09:28,600 FIELD I DON'T WANT TO BUTCHER 1851 01:09:28,600 --> 01:09:29,880 THE FINDINGS BUT THAT'S TRUE. 1852 01:09:29,880 --> 01:09:32,520 THERE HAVE BEEN OTHER VERY 1853 01:09:32,520 --> 01:09:37,680 POSITIVE IMMUNOLOGIC FINDINGS AS 1854 01:09:37,680 --> 01:09:37,880 WELL. 1855 01:09:37,880 --> 01:09:39,200 >> VERY INTERESTING. 1856 01:09:39,200 --> 01:09:40,400 A LITTLE HOPEFUL, RIGHT? 1857 01:09:40,400 --> 01:09:47,320 THERE SEEMS TO BE A LOT COMING 1858 01:09:47,320 --> 01:09:48,480 IN ABOUT OVERARCHING BENEFITS OF 1859 01:09:48,480 --> 01:09:49,960 PAYING ATTENTION TO THE TIME OF 1860 01:09:49,960 --> 01:09:51,560 DAY YOU TAKE IN YOUR ENERGY, HOW 1861 01:09:51,560 --> 01:09:54,400 THE BODY HAS DEVELOPED IN ORDER 1862 01:09:54,400 --> 01:09:56,040 TO PRIORITIZE THE INTAKE OF 1863 01:09:56,040 --> 01:09:59,760 ENERGY VERSUS THE USE OF ENERGY 1864 01:09:59,760 --> 01:10:00,560 THROUGHOUT THE DAY. 1865 01:10:00,560 --> 01:10:02,200 >> I THINK THE MECHANISM -- 1866 01:10:02,200 --> 01:10:05,920 WE'LL FIND THE MECHANISMS ARE 1867 01:10:05,920 --> 01:10:08,520 HETEROGENEOUS, AND SOME COULD 1868 01:10:08,520 --> 01:10:10,080 LOOSELY RELATED TO CIRCADIAN 1869 01:10:10,080 --> 01:10:13,600 SYSTEMS, SOME MAY NOT BE. 1870 01:10:13,600 --> 01:10:14,800 IT WILL BE A RICH FIELD AND 1871 01:10:14,800 --> 01:10:18,200 CONTINUE TO BE SO IN THE FUTURE. 1872 01:10:18,200 --> 01:10:21,440 >> WELL, FANTASTIC. 1873 01:10:21,440 --> 01:10:22,360 ONE MORE QUESTION. 1874 01:10:22,360 --> 01:10:24,320 ALIGNS WITH ONE OF OUR CRITICAL 1875 01:10:24,320 --> 01:10:29,120 OPPORTUNITIES IN THE NIH SLEEP 1876 01:10:29,120 --> 01:10:31,520 RESEARCH PLAN. 1877 01:10:31,520 --> 01:10:32,920 SPECIFICALLY, SHOULD THE MEAL 1878 01:10:32,920 --> 01:10:35,480 TIME OFF, MEAL TIME OFF, BE 1879 01:10:35,480 --> 01:10:37,360 BASED ON A TYPICAL BEDTIME OR 1880 01:10:37,360 --> 01:10:41,680 ULTIMATELY IS THERE A MORE 1881 01:10:41,680 --> 01:10:44,320 SPECIFIC BIOMARKER OF ENDOGENOUS 1882 01:10:44,320 --> 01:10:47,400 CIRCADIAN RHYTHM, LET'S SAY DIM 1883 01:10:47,400 --> 01:10:49,560 LIGHT, MELATONIN ONSET, THE OR 1884 01:10:49,560 --> 01:10:52,000 MONEY THAT HELPS DRIVE THAT 1885 01:10:52,000 --> 01:10:55,040 SLEEP NEED, OR THAT SLEEP WANT, 1886 01:10:55,040 --> 01:10:55,800 IN THE EVENING. 1887 01:10:55,800 --> 01:10:59,680 THAT WOULD BE A BETTER TIME WHEN 1888 01:10:59,680 --> 01:11:00,200 TO STOP EATING? 1889 01:11:00,200 --> 01:11:00,920 >> GREAT QUESTION. 1890 01:11:00,920 --> 01:11:03,280 YOU CAN IMAGINE ALL KINDS OF 1891 01:11:03,280 --> 01:11:06,200 VERY FRUITFUL PUBLIC HEALTH 1892 01:11:06,200 --> 01:11:07,560 RECOMMENDATIONS BASED ON CUTOFF 1893 01:11:07,560 --> 01:11:08,520 TIME. 1894 01:11:08,520 --> 01:11:10,040 SO, THIS IS ACTUALLY ALSO AN 1895 01:11:10,040 --> 01:11:12,120 AREA OF RESEARCH THAT'S POPULAR 1896 01:11:12,120 --> 01:11:13,600 IN EPIDEMIOLOGIC RESEARCH. 1897 01:11:13,600 --> 01:11:15,280 STARTING TO SEE A NUMBER OF 1898 01:11:15,280 --> 01:11:16,480 STUDIES COMING THROUGH THE 1899 01:11:16,480 --> 01:11:17,600 PIPELINE WHERE PEOPLE ARE ASKING 1900 01:11:17,600 --> 01:11:20,240 WHAT IS THE OPTIMAL CUTOFF FROM 1901 01:11:20,240 --> 01:11:21,280 A POPULATION HEALTH PERSPECTIVE. 1902 01:11:21,280 --> 01:11:23,360 I CAN TELL YOU MECHANISTICALLY 1903 01:11:23,360 --> 01:11:27,320 WE KNOW AS SOON AS MELATONIN 1904 01:11:27,320 --> 01:11:30,600 LEVELS ARE ELEVATED THAT INDUCES 1905 01:11:30,600 --> 01:11:31,280 INSULIN RESISTANCE. 1906 01:11:31,280 --> 01:11:33,160 WE EXPECT THAT INFORMATION ON 1907 01:11:33,160 --> 01:11:34,560 DIM LIGHT MELATONIN ONSET OR 1908 01:11:34,560 --> 01:11:36,200 WHEN LEVELS START TO RISE IN 1909 01:11:36,200 --> 01:11:37,800 PEOPLE WOULD BE REALLY IMPORTANT 1910 01:11:37,800 --> 01:11:38,400 IN DETERMINING CUTOFF. 1911 01:11:38,400 --> 01:11:40,120 BUT I DON'T THINK WE KNOW ENOUGH 1912 01:11:40,120 --> 01:11:41,880 TO EXACTLY KNOW WHERE TO PUT 1913 01:11:41,880 --> 01:11:42,080 THAT. 1914 01:11:42,080 --> 01:11:45,920 SO I THINK THIS IS SUCH A GREAT 1915 01:11:45,920 --> 01:11:46,280 QUESTION. 1916 01:11:46,280 --> 01:11:50,200 IN PARALLEL THERE'S A LINE OF 1917 01:11:50,200 --> 01:11:52,600 FIELD DEVELOPING, YOU MENTIONED 1918 01:11:52,600 --> 01:11:55,680 A BIOMARKERS TO MEASURE EACH 1919 01:11:55,680 --> 01:11:57,320 PERSON'S RHYTHM. 1920 01:11:57,320 --> 01:11:58,640 I SAW GREAT QUESTIONS ABOUT 1921 01:11:58,640 --> 01:11:59,720 PERSONALIZING IN A. 1922 01:11:59,720 --> 01:12:02,680 THERE'S GOING TO BE AN IMPORTANT 1923 01:12:02,680 --> 01:12:05,080 ROLE FOR PRECISION NUTRITION 1924 01:12:05,080 --> 01:12:12,960 BASED ON UNDERLYING CIRCADIAN 1925 01:12:12,960 --> 01:12:13,200 RHYTHMS. 1926 01:12:13,200 --> 01:12:14,280 EXCITING PROGRESS BUT THE 1927 01:12:14,280 --> 01:12:16,240 PRECISION IS NOT THERE YET IS MY 1928 01:12:16,240 --> 01:12:18,560 UNDERSTANDING, IN TERMS OF 1929 01:12:18,560 --> 01:12:20,280 DEVELOPING A SINGLE BIOMARKER 1930 01:12:20,280 --> 01:12:21,920 FROM A BLOOD SAMPLE, BUT VERY 1931 01:12:21,920 --> 01:12:23,600 COOL WORK BEING DONE IN THAT 1932 01:12:23,600 --> 01:12:23,880 AREA. 1933 01:12:23,880 --> 01:12:25,320 LET ME ADD ONE CAVEAT. 1934 01:12:25,320 --> 01:12:29,920 ONE THING TO THINK ABOUT IS 1935 01:12:29,920 --> 01:12:33,880 WHICH CIRCADIAN RHYTHMS ARE 1936 01:12:33,880 --> 01:12:34,320 MALLEABLE. 1937 01:12:34,320 --> 01:12:36,840 THERE'S A REALLY GOOD BODY OF 1938 01:12:36,840 --> 01:12:38,280 DATA SUGGESTING THAT GLYCEMIC 1939 01:12:38,280 --> 01:12:40,120 CONTROL IN INDIVIDUALS WITH TYPE 1940 01:12:40,120 --> 01:12:43,320 2 DIABETES PEAKS IN THE EVENING, 1941 01:12:43,320 --> 01:12:45,600 THERE'S A NICE STUDY OUT OF 1942 01:12:45,600 --> 01:12:47,920 CHINA SHOWING AROUND INSULIN 1943 01:12:47,920 --> 01:12:48,760 SENSITIVITY PEAKS AROUND 7:00 1944 01:12:48,760 --> 01:12:49,520 P.M. 1945 01:12:49,520 --> 01:12:51,400 YOU THINK MAYBE WE SHOULD SHIFT 1946 01:12:51,400 --> 01:12:53,240 FOOD INTAKE TO THE EVENING FOR 1947 01:12:53,240 --> 01:12:57,000 FOLKS WITH TYPE 2 DIABETES BUT 1948 01:12:57,000 --> 01:12:58,880 RESEARCH SHOWS THEY TEND TO 1949 01:12:58,880 --> 01:12:59,720 BENEFIT FROM EATING EARLY IN THE 1950 01:12:59,720 --> 01:13:01,680 DAY SO MAYBE IT'S A MISALIGNED 1951 01:13:01,680 --> 01:13:03,440 RHYTHM THAT NEEDS TO BE 1952 01:13:03,440 --> 01:13:05,640 CORRECTED. 1953 01:13:05,640 --> 01:13:07,400 JUST BECAUSE RHYTHM PEAKS OR AT 1954 01:13:07,400 --> 01:13:09,480 A DIFFERENT TIME OF DAY WE DON'T 1955 01:13:09,480 --> 01:13:11,440 KNOW THE DEGREE THAT'S INTRINSIC 1956 01:13:11,440 --> 01:13:12,960 VERSUS MALLEABLE OR THERE'S MORE 1957 01:13:12,960 --> 01:13:17,000 WORK TO BE DONE IN A THAT AREA 1958 01:13:17,000 --> 01:13:19,120 AND THERE MAY BE MORE 1959 01:13:19,120 --> 01:13:19,880 MALLEABILITY THAN WE THINK. 1960 01:13:19,880 --> 01:13:22,840 >> A LOT TO UNPACK HERE. 1961 01:13:22,840 --> 01:13:24,880 IT SEEMS LIKE THERE'S A TON OF 1962 01:13:24,880 --> 01:13:26,080 OPPORTUNITY FOR NEW RESEARCH 1963 01:13:26,080 --> 01:13:30,120 THAT'S GOING TO LEAD TO REALLY 1964 01:13:30,120 --> 01:13:31,800 GREAT PUBLIC HEALTH 1965 01:13:31,800 --> 01:13:32,880 RECOMMENDATIONS IN THE FUTURE. 1966 01:13:32,880 --> 01:13:34,640 IT'S GREAT THIS IS SOMETHING 1967 01:13:34,640 --> 01:13:37,280 THAT PEOPLE CAN DO BEHAVIORALLY. 1968 01:13:37,280 --> 01:13:39,440 SO IT'S NOT GOING TO BE 1969 01:13:39,440 --> 01:13:40,640 DEPENDENT ON MAKING SURE YOU'RE 1970 01:13:40,640 --> 01:13:42,960 KEEPING UP WITH YOUR MEDICATION, 1971 01:13:42,960 --> 01:13:43,880 ALSO IMPORTANT, BUT SOMETHING WE 1972 01:13:43,880 --> 01:13:45,840 CAN START TO DO FOR YOURSELF, 1973 01:13:45,840 --> 01:13:49,120 PAY ATTENTION FOR YOURSELF TO 1974 01:13:49,120 --> 01:13:50,200 BENEFIT YOUR FUTURE HEALTH. 1975 01:13:50,200 --> 01:13:51,240 >> YES. 1976 01:13:51,240 --> 01:13:54,880 >> I DO WANT TO SAY THANK YOU 1977 01:13:54,880 --> 01:13:59,040 SO MUCH FOR THIS -- FOR SHARING 1978 01:13:59,040 --> 01:14:02,440 AMAZING INSIGHTS ON THIS TOPIC. 1979 01:14:02,440 --> 01:14:03,840 I THANK EVERYONE FOR JOINING, 1980 01:14:03,840 --> 01:14:07,880 STAYING ON, CONTRIBUTING TO THE 1981 01:14:07,880 --> 01:14:08,280 QUESTIONS. 1982 01:14:08,280 --> 01:14:14,680 I'LL PLUG THE WORKSHOP ON 1983 01:14:14,680 --> 01:14:16,120 CHRONONUTRITION, MAY 2 AND MAY 1984 01:14:16,120 --> 01:14:16,240 3. 1985 01:14:16,240 --> 01:14:17,760 FIND THE INFORMATION ON THE 1986 01:14:17,760 --> 01:14:19,320 NHLBI PUBLIC WEBSITE UNDER 1987 01:14:19,320 --> 01:14:19,720 EVENTS. 1988 01:14:19,720 --> 01:14:23,360 PLEASE STAY TUNED FOR FUTURE 1989 01:14:23,360 --> 01:14:26,200 ONPI SEMINARS LATER THIS YEAR. 1990 01:14:26,200 --> 01:14:27,240 I HOPE EVERYONE HAS GOTTEN 1991 01:14:27,240 --> 01:14:28,000 SOMETHING WONDERFUL OUT OF THE 1992 01:14:28,000 --> 01:14:28,200 PRESENTATION AND HAS A WONDERFUL 1993 01:14:28,200 --> 00:00:00,000 REST OF YOUR DAY.