<markdown>

@Megan Ramos 回答了关于间歇乏食的各种问题，包括低BMI人群是否可以进行间歇乏食，如何利用间歇乏食治疗多囊卵巢综合征（PCOS）并为怀孕做准备，间歇乏食是否会损害甲状腺，以及夜班工作人员如何进行间歇乏食并保持健康。

对于低BMI的人群，在开始间歇乏食之前，建议先进行DEXA扫描和血液检查，以评估身体成分和营养状况。如果内脏脂肪过多，可以进行24小时乏食，每周2-3次。

对于PCOS患者，建议先解决胰岛素抵抗，然后优化性激素。月经周期的第一周是进行长时间乏食的最佳时间。

对于亚临床甲状腺功能减退症，建议在早餐后开始乏食，并注意在进行血液检查时避免乏食。

夜班工作人员应准备健康食物，并在最后一次进食和睡觉之间至少间隔3-4小时。

低BMI人群是否可以间歇性禁食？

一位来自北卡罗来纳州的Beth提问：冯博士提到他不建议BMI低于20的人乏食。我的BMI低于20，最近我的糖化血红蛋白（A1C）从6.2降到了5.5，但我想进一步降低或至少维持这个水平。间歇乏食或OMAD（一天一餐）适合我吗？

答：BMI并非衡量健康的完美指标。在开始间歇乏食前，建议先进行DEXA身体成分扫描，评估内脏脂肪和瘦体重比例。如果内脏脂肪过多，瘦体重不足，则需要进行血液检查，评估营养状况。如果存在营养缺乏，应先补充营养，待身体状况改善后再考虑间歇乏食。对于内脏脂肪过多的人群，可以尝试每周2-3次24小时乏食，其他时间则进行温和的间歇乏食（例如14-18小时）。目标并非单纯减重，而是增加瘦体重，改善身体成分。

如何利用间歇乏食治疗PCOS并为怀孕做准备？

来自荷兰的Miggy提问：我一直在进行治疗性乏食以解决我的PCOS，并希望恢复月经。您对乏食和营养的孕前计划有什么建议？尝试怀孕前我应该做些什么？我该如何知道我的身体是否足够健康？

答：PCOS本质上是卵巢的糖尿病，治疗的关键在于先解决胰岛素抵抗。这可以通过低碳水饮食或生酮饮食，结合治疗性乏食来实现。月经周期的第一周，由于孕酮水平下降，雌二醇水平上升，是进行长时间乏食的最佳时机。在排卵期后，应减少乏食时间，并增加碳水化合物的摄入，以支持孕酮的产生。孕前准备的关键在于补充营养，特别是叶酸、胆碱等。建议进行微量营养素检测，并根据结果补充营养，为怀孕打下坚实的基础。这个过程通常需要6个月左右。

间歇乏食是否会损害甲状腺？

来自荷兰的Miggy还提问：间歇乏食是否会损害甲状腺？我的甲状腺曾出现亚临床低甲状腺功能减退，但在停止乏食后恢复正常，无需药物治疗。我现在又开始进行隔日乏食了，因为我非常喜欢乏食。

答：间歇乏食本身不会损害甲状腺，但需要谨慎。如果出现亚临床低甲状腺功能减退，建议在早餐后开始乏食，这有助于防止T4转化为反向T3。进行甲状腺激素检测时，应避免乏食状态，建议在停止乏食2-3天后进行检测。一些研究表明，间歇乏食可以降低炎症，而炎症可能是亚临床低甲状腺功能减退的原因。建议检查微量营养素（如硒、碘、铁）水平，并根据结果进行补充。

夜班工作人员如何进行间歇乏食并保持健康？

来自南卡罗来纳州的Suzy提问：我在医院做夜班已经30年了，每天晚上7点到早上7点。我想知道如何在夜班期间保持尽可能健康，以及在这种情况下最佳的乏食方式。

答：夜班工作者应提前准备健康食物，避免医院内不健康的饮食诱惑。建议在上班前吃一顿丰盛的晚餐，并在工作期间只吃一顿饭。下班后，应在最后一次进食和睡觉之间至少间隔3-4小时。

总结

间歇乏食是一种有效的健康工具，但需要根据个人情况进行调整。在开始间歇乏食前，建议进行全面的身体评估，并咨询医疗专业人士的意见。 尤其对于BMI较低、患有PCOS或甲状腺疾病的人群，更需谨慎，并制定个性化的乏食计划。 对于夜班工作者，则需要注重饮食规划和作息安排，以保持健康。

◉

00:12 黄体酮是促进食欲的激素，而雌二醇是抑制食欲的激素。因此，到第三天，我们的黄体酮下降，雌二醇上升。

◉

00:41 在月经周期的第一天进行间歇乏食是最佳的，因为此时激素水平有利于乏食，并且情绪和胰岛素敏感性也更好。

◉

01:32 我听说冯博士提到他不建议BMI低于20的人乏食，我的BMI低于20，最近我的糖化血红蛋白从6.2降到了5.5，但我想进一步降低它，或者至少保持它。间歇乏食或OMAD可以吗？

◉

01:51 乏食前必须确保个体营养充足，BMI并非衡量营养状况的良好指标。

◉

02:15 BMI低的个体禁食前应进行DEXA扫描和血液检查，以评估身体成分和营养状况。

◉

02:39 BMI低的个体禁食前应进行DEXA扫描和血液检查，以评估身体成分和营养状况。

◉

03:01 如果DEXA扫描显示体内脂肪过多，则应进行血液检查以评估营养状况，如有缺乏则需补充。

◉

03:23 如果DEXA扫描显示体内脂肪过多，则应进行血液检查以评估营养状况，如有缺乏则需补充。

◉

03:36 对于BMI低的个体，增加健康体重（肌肉和骨骼质量）可能比单纯减脂更重要。

◉

04:03 增加健康体重（肌肉和骨骼质量）可能比单纯减脂更重要。

◉

04:20 增加健康体重（肌肉和骨骼质量）可能比单纯减脂更重要。

◉

05:15 对于内脏脂肪较少、BMI低的个体，不建议进行长时间禁食，可采用时间限制饮食法。

◉

05:22 对于内脏脂肪较少、BMI低的个体，不建议进行长时间禁食，可采用时间限制饮食法，并注重蛋白质摄入和肌肉增长。

◉

05:48 对于内脏脂肪较多的人，建议进行24小时禁食，每周2-3次，以减少内脏脂肪。

◉

06:00 内脏脂肪可以通过24小时禁食有效减少，皮下脂肪则可能需要更长时间的禁食。

◉

06:23 对于BMI低的个体，应在进行间歇性禁食的同时，注重蛋白质摄入和肌肉增长，目标是增加瘦体重，而不是单纯减脂。

◉

06:53 体重秤只能显示总体重，而不能反映身体成分（脂肪和肌肉比例）。

◉

07:12 体重秤只能显示总体重，而不能反映身体成分（脂肪和肌肉比例），健康体重应考虑身体成分。

◉

07:33 进行DEXA扫描和微量营养素检测，以评估身体成分和营养状况。

◉

07:59 进行DEXA扫描和微量营养素检测，以评估身体成分和营养状况。

◉

08:16 在开始禁食前，应咨询医疗保健提供者。

◉

08:42 对于BMI低的个体，应谨慎进行禁食，建议咨询禁食教练。

◉

09:06 A1c值低于5.5仍有优化空间，可能需要增加健康体重。

◉

11:14 我一直在进行治疗性禁食以解决我的多囊卵巢综合征（PCOS），并希望恢复我的月经。您对禁食和营养的孕前计划有什么建议？尝试怀孕前我应该做些什么？我该如何知道我的身体是否足够健康？

◉

11:37 治疗PCOS的关键是首先解决胰岛素抵抗，然后优化性激素。

◉

13:08 备孕期间应进行微量营养素检测，补充营养，并服用叶酸。

◉

13:23 推荐使用Weenadal品牌的产前维生素和补充剂。

◉

13:52 备孕期间应进行微量营养素检测，补充营养，并服用叶酸。

◉

14:08 建议在备孕前3个月优化营养状况。

◉

14:36 建议在备孕前6个月优化营养状况。

◉

15:02 建议在备孕前6个月优化营养状况，这将为孩子的未来奠定基础。

◉

15:36 治疗PCOS应先解决胰岛素抵抗，再优化性激素。

◉

16:24 治疗PCOS应先解决胰岛素抵抗，再优化性激素。

◉

17:16 月经周期的第一周是进行长时间禁食的最佳时间。

◉

17:43 月经周期的第一周是进行长时间禁食的最佳时间，因为此时激素水平有利于禁食。

◉

18:08 月经周期的第一周是进行长时间禁食的最佳时间，因为此时激素水平有利于禁食。

◉

18:56 月经周期不同阶段的禁食策略应有所不同。

◉

19:19 月经周期不同阶段的禁食策略应有所不同。

◉

19:44 对于PCOS患者，应先进行禁食以控制胰岛素抵抗，然后根据月经周期调整禁食和饮食策略。

◉

20:13 大多数女性需要4-6个月才能恢复规律月经周期。

◉

21:58 禁食是否会损害甲状腺？我的甲状腺功能低，但在停止禁食后恢复正常，现在又开始间歇性禁食。

◉

22:16 禁食本身不会损害甲状腺，但应注意自身耐受程度，并检查甲状腺水平。

◉

22:42 对于反向T3型甲状腺功能减退症，建议在早餐后开始禁食。

◉

23:10 进行激素和血脂检测时，应避免禁食。

◉

23:36 进行激素和血脂检测时，应避免禁食。

◉

24:02 进行激素和血脂检测时，应避免禁食。

◉

24:31 禁食期间进行的血液检查结果可能不准确。

◉

24:56 禁食可能会降低炎症，从而改善亚临床甲状腺功能减退症。

◉

25:03 禁食可能会降低炎症，从而改善亚临床甲状腺功能减退症。

◉

25:32 禁食可能会降低炎症，从而改善亚临床甲状腺功能减退症。

◉

25:54 治疗亚临床甲状腺功能减退症应检查营养状况和肾上腺功能。

◉

26:14 治疗亚临床甲状腺功能减退症应检查营养状况和肾上腺功能。

◉

26:40 治疗亚临床甲状腺功能减退症应检查营养状况和肾上腺功能，包括皮质醇、硒、碘和铁水平。

◉

27:05 我在医院做夜班已经30年了，每天晚上7点到早上7点。我想知道如何在夜班期间保持尽可能健康，以及在这种情况下最佳的禁食方式。

◉

27:24 夜班工作者应准备健康食物，以避免不健康饮食的诱惑。

◉

27:46 夜班工作者应准备健康食物，以避免不健康饮食的诱惑。

◉

28:00 夜班工作者应准备健康食物，以避免不健康饮食的诱惑。

◉

28:19 夜班工作者应提前准备食物，并选择易于携带和保存的食物。

◉

28:41 夜班工作者可以考虑在上班前和下班后各吃一顿饭。

◉

29:02 夜班工作者可以考虑在上班前和下班后各吃一顿饭，并确保饮食多样化。

◉

29:29 夜班工作者可以考虑在上班前和下班后各吃一顿饭，并确保饮食多样化。

◉

29:49 夜班工作者应确保最后一次进食和睡觉之间至少间隔3-4小时。

00:00

Progesterone is an appetite driving hormone where estradiol is an appetite suppressing hormone. So by day three, our progesterone's down, our estradiol is up. 语法解析

00:12

we are hormonally programmed to be very effective at doing fasting. We also emotionally feel better at this particular time, so there's less sort of emotional eating drivers. And at this particular time, we're also the most insulin sensitive in our cycle as well. So this is a great time to further enhance that or support that, especially if there are some insulin resistant issues going on. 语法解析

00:41

Hi everyone, it's Megan Ramos here with another episode of the Fasting Method Podcast. Today I'm going to answer your questions. We're going to tackle topics such as why it's best to do extended fasting during the first week of your cycle. Is it safe to fast when you have hypothyroidism? And what about BMI? How much does that factor in to whether or not you should be fasting? 语法解析

01:10

All right, so we're going to kick it off with that last one. Beth from North Carolina says, I've heard Dr. Fung mention that he does not recommend fasting for people with a body mass index or BMI under 20. My BMI is under 20. I've recently lowered my hemoglobin A1c from 6.2 to 5.5%. 语法解析

01:32

but I would like to lower it further or at least maintain it. Would IF or OMAD, which is one meal a day, be okay to do? This is a really great question. It's really important that individuals are not malnourished when they are fasting. 语法解析

01:51

So someone who generally has a lower BMI, we assume they don't have a ton of body fat, not a lot that's going to sustain them when they're fasting. But what we do know is that body mass index or BMI is not a really good measurement of anything. So if you are on the lower side of your total weight, 语法解析

02:15

There's a few things that I would recommend doing before you decide whether or not you're going to start fasting. The first one is have a DEXA body composition scan. Do you hold excess body fat, visceral fat, that unhealthy fat in and around your organs, subcutaneous fat? Are you what we call a TOFI, someone who's thin on the outside and fat on the inside? 语法解析

02:39

If your dexed body composition does show that you have an unhealthy amount of body fat and you have a subpar amount of lean mass in your body, meaning that you might have weaker brittle bones or that you might not have very much muscle mass or deteriorating muscle mass, something called sarcopenia, then this is where I move on to step two. 语法解析

03:01

So if you do your dexabody composition scan and it shows that you do have a higher level of body fat, then lean mass, go on to level two here and get some blood work done. Make sure all your nutrient stores are good. And if you have any nutrient deficiencies, then take care of them, recheck in a few months and then begin your fasting journey. But 语法解析

03:23

But sometimes when we have a little bit too much body fat and we don't have enough lean mass, the answer isn't always necessarily losing more body fat. 语法解析

03:36

Sometimes the answer is putting on good lean mass, fixing those brittle bones if your bone mass density is low, getting on some good muscle mass. So putting on a little bit of weight, but healthy weight. So not all weight is unhealthy. I often share that throughout my journey, I hit a low of 97 pounds, but I had more body fat at 97 pounds than I did at 120 pounds. 语法解析

04:03

How can that be? Well, I did have to lose a little bit of body fat, but I mostly gained good weight. And gaining the good weight, increasing the ratio of good weight, muscle mass and bone mass, which I didn't have very much of at 97 pounds, that's what brought my weight up. 语法解析

04:20

And bringing my weight up in a healthy way lowered my body fat percentage down significantly. So when I weighed 97 pounds and my body fat percentage was around 37%, the goal wasn't to get to 60 pounds. That was not the goal. That, of course, would have been unhealthy. The goal was to put on healthy weight. And I did have a little bit too much visceral fat, according to my Dexabody composition scan. So I did have to lose a couple of pounds. 语法解析

04:49

So when someone comes to me who is very slender, we look at these things. Are you a toffee? Are you someone who's thin on the outside, fat on the inside? How much visceral fat is that Dexascan saying that you have? If it's under two pounds, then I say, you know what? Therapeutic fasting really isn't for you. You can do 12 or 14 hours regularly. You can do 16, 18 hours. You can focus on really good time restricted eating protocols. 语法解析

05:15

but really try to get in some good protein and just focus on building some lean mass. 语法解析

05:22

Now when someone has a little bit too much visceral fat, okay, let's do some intermittent fasting. We would be very gentle just doing 24 hours of fasting, not every day, two or three times a week to target that visceral fat. 24 hours of fasting is actually very effective at targeting that visceral fat. You don't need to do 36, 42, 48. You don't need to do three days or five days to target that visceral fat. 语法解析

05:48

Subcutaneous fat can be a little bit more stubborn and sometimes we benefit from doing longer fasts for that. But visceral fat, we can pretty much obliterate in a good 24 hour consistent fasting pattern. 语法解析

06:00

With this individual, again, if we did have that higher visceral fat and we would do those 24s two to three times a week, we would do anywhere from 14 to 18 hours of fasting on the other days, really prioritizing protein and a nutrient-dense diet just to help aid in the development of some healthy weight, good bone mass density, good muscle mass. And the goal 语法解析

06:23

would to actually be to increase lean mass. So increase your total weight while losing a little bit of fat mass. So we wouldn't want the scale to actually go up kind of in the end, but being reflective of healthy weight. 语法解析

06:38

It's important to remember that the scale only tells you your total weight, but it doesn't tell you what that total weight is. Is it mostly fat or is it mostly muscle? Now I'm five foot three and around 120 pounds when I have little fat. 语法解析

06:53

and more muscle and more strong bones is a really good spot for me. But if I weighed 120 pounds and I had a lot of fat and I had osteopenia or osteoporosis and sarcopenia, so my lean mass is really low, then I'd be unhealthy and I'd be at risk of all kinds of metabolic concerns. 语法解析

07:12

So this is where the total number on the scale can be really misleading and it's important to know your body composition and a DEXA body composition scan can tell you all of these departments so you know what to do. And then going for micronutrient testing, you can do standard micronutrient testing in almost any lab if you're in the United States. 语法解析

07:33

It's Genova and SpectraCell do some more in-depth, detailed micronutrient testing. I personally have alternated between using both depending on just sort of what's going on at each company when I could get faster results, what my doctor's preference was because I'm in California and do require a doctor to order it for me. They're both really great tests. They're ones that I also recommend to people that I work with. 语法解析

07:59

And then we want to make sure that we've tackled any of those nutrient deficiencies. Most importantly, you need to get your health care provider on board. You should never fast without having a cooperative and supportive physician or health care practitioner giving you the thumbs up. 语法解析

08:16

Now again, we would sort of cap it at 24 hours. We would add in some strength and resistance training. We would really try to focus on optimizing the nutrients and the protein in the diet to help gain some good weight. So we can't always necessarily go by BMI, but BMI does pop up a little bit of a flag where we need to assess these things before we can determine whether or not it's safe. 语法解析

08:42

When someone has an A1c of 6.2 and they're on the lower side of things, chances are they are a bit of a toffee. We know that we want to optimize our A1c and an optimized A1c is 5.2 or below. So at 5.5, there could still be a further bit of optimization. I wouldn't be surprised if this individual does have a little bit of visceral fat. 语法解析

09:06

but they probably don't need to lose body fat, maybe half a pound if that, and it's about putting on some healthy weight. So as long as we follow all the proper protocols, we have that healthcare provider on board, then we would transition into some strategic fasting strategies. 语法解析

09:26

With that being said, in this particular set of circumstances, it would be most advisable to work with a coach who can navigate this with you safely. So this is one of those instances where I would really recommend connecting with a fasting coach. You can learn more about coaching over on thefastingmethod.com. Have you ever thought, I am my worst enemy when it comes to weight loss or health goals? If so, you are not alone. 语法解析

09:56

But this barrier does not need to keep holding you back. I'm offering a self-sabotage workshop that can end this pattern of defeat. Together, we will explore the root causes of your self-sabotage and create strategies to overcome the thoughts and behaviors that have been preventing you from feeling the success that you are seeking. 语法解析

10:19

You will learn to proactively avoid the pitfalls that have kept you feeling stuck and develop new responses to triggers that have served as roadblocks for years. Join me at TFM for my self-sabotage workshop that begins in May. The links are in the show notes. You can also enjoy 10% off any of the workshops and masterclasses we are offering from now until November on the TFM website. 语法解析

10:48

This includes the three pack and six pack bundles, as well as the all access pass using the coupon code podcast 10 capital P O D C A S T 10. The next question says I have been doing therapeutic fasting to address my polycystic ovary syndrome or PCOS and hopefully get my curated back. 语法解析

11:14

Do you have any recommendations for a preconception plan for fasting and nutrition? Is there anything I should be doing before trying to conceive? How will I know my body is healthy enough? Oh, my friend, I could probably do a whole podcast series just on this alone. If you've been following my journey, when I was young, I had PCOS. 语法解析

11:37

I was able to correct it in my 20s by targeting and treating the insulin resistance first and then optimizing my sex hormones later. But because I developed PCOS so young and had it for about 15 years before I was able to treat it, before I knew what to do, before I even knew that I could treat it, I had burned through a lot of my ovarian reserves. 语法解析

12:01

So I was 38, trying to get pregnant and I didn't have much in terms of ovarian reserves. Knowing that I wanted to have a couple of kids, 语法解析

12:11

And my second kid would probably be born in my 40s if I was lucky. I ended up doing three rounds of IVF to bank embryos just to guarantee that I could likely, hopefully, have a second baby as I got older because in my early 40s, I wouldn't have these ovarian reserves. So I feel like since I was 14 years old and I am going to be 41 soon, I've spent a lot of my life 语法解析

12:38

My personal health focus has been on treating these things. Now, I never lost my period with PCOS. I always did have a regular period with PCOS, but so many women that we work with don't. 语法解析

12:51

So one of the best things you can do is you're looking to try to conceive, regardless of whether you have PCOS or not, is get that micronutrient testing. Build your nutrient stores back up. Take a pre-methylated folate. 语法解析

13:08

The brand of prenatals that I use is Weenadal. I have no affiliation with the brand. I have talked to the founders of the brand. They have occasionally sent me some samples, but I do pay out of pocket every single month. 语法解析

13:23

They also have an egg optimization supplement that recently came out and they have a DHA supplement. Now I have all my embryos on ice, so I still take their prenatal because it's got that pre-methylated folate in it. It's got choline in it. But the most important thing you can do as soon as possible in your preconception journey is to test your micronutrients and bring them up to where they need to be to those optimal levels. 语法解析

13:52

And once they're there, then that's when I would begin trying to conceive. I, in my own journey ahead of doing IVF, I knew that it was coming up and I spent a solid three months because the egg lifespan is three months. 语法解析

14:08

I spent three months making sure that I was optimizing every single one of these every day either through nutrition first and foremost always through nutrition or if there were some obvious deficiencies in your nutrition through supplementation and monitoring this very very closely. It's the most important thing that you can do again PCOS or not whether you're 22 years old or 42 years old or anywhere in between looking trying to conceive 语法解析

14:36

You want to get a head start on this. And if you can give yourself six months to do it, even better. Now, I was in a unique position because when I did my initial baseline micronutrient testing, I was almost optimal across the board. Obviously, I know a little bit about nutrition and for many years had been working on optimizing things. But if you're just starting, you want to give yourself six months. It will make a world of difference. 语法解析

15:02

And ladies out there, I know how eager it can be to want to be a mama. But this six months just totally radically sets a foundation for your kids' future. It's the most important thing that you'll do. 语法解析

15:15

All right. Now back to the whole fasting topic, which most of you are here for. PCOS is a form of diabetes of the ovaries. It's essentially diabetes of the ovaries. The advice that Jason and I have always given has been quite different from those of other functional female hormone specialists. 语法解析

15:36

our peers who we respect so much, they often really try to optimize the sex hormones as much as possible through nutritional strategies and over time see the insulin resistance improve. And these strategies are a little 语法解析

15:54

bit different than what we would do with insulin resistance. So a little bit less fasting during the second half of the cycle, a little bit more carbs during the second half of the cycle. But when someone has insulin resistance and that's causing PCOS, 语法解析

16:10

Jason and I have just always found it being so much more successful is treating the insulin resistance first, obliterating the insulin resistance, and then optimizing those sex hormones secondary. 语法解析

16:24

So what I'm talking about is we would treat you just like a diabetic. We would focus on doing a very low carb or ketogenic diet, depending on sort of your adrenal needs, someone who has some adrenal issues going on, if it's on the lower end of the side of things, more sort of adrenal fatigue or insufficiency, HP axis dysfunction. We would be sort of more of a moderate to liberal low carb diet. 语法解析

16:51

if someone's got more cortisol issues in sort of the opposite direction or is cortisol healthy, you know, then we focus as lower a low carb or a ketogenic diet to help. And then we would do therapeutic fasting. The first week of your cycle is actually the best week to do extended fasting, extended fasting for you at the start of your journey might look like something 24 to 48 hours. 语法解析

17:16

As your journey progresses, it might look like something 48 hours, three days or five days. But usually around day three of your cycle is when you plan extended fasts. Even for myself, today's day and age, I always calendar pencil in any extended fasts I do to be starting on day three of my cycle. Why is that? It's the most hormonally easy time to do an extended fast. 语法解析

17:43

As day one of our cycle happens, our progesterone levels are coming down quickly and our estrogen levels are shooting up very quickly. Now, by day one of your cycle, your progesterone levels have kind of dipped already. Progesterone is an appetite-driving hormone where estradiol is an appetite-suppressing hormone. So by day three, our progesterone's down, our estradiol is up. 语法解析

18:08

we are hormonally programmed to be very effective at doing fasting. We also emotionally feel better at this particular time, so there's less sort of emotional eating drivers. And at this particular time, we're also the most insulin sensitive in our cycle as well. So this is a great time to further enhance that or support that, especially if there are some insulin resistant issues going on. 语法解析

18:32

Once ovulation happens, we do notice that the appetite starts to bump up a little bit. And that particular time we start to see estradiol come down over the next seven days and progesterone go up over the next seven days. And then that week before our cycle is when we struggle the most with fasting. So during week one of a woman's cycle, we tend to do extended fasts. 语法解析

18:56

or whatever that might mean for you. As we approach ovulation, we still try to stay in that therapeutic range of 24 to 48 hours. As we go just post ovulation, 24 hours, and then that week before the period, we focus on just good time-restricted eating. And if we're trying to conceive, we do add more carbs. 语法解析

19:19

root vegetables, I'll be specific, not just all carbs, root vegetables, we start adding in after ovulation to support progesterone. But when you are first starting out with this, you don't have a period, you don't have a cycle to even know because the insulin resistance is so bad, then we just fast as much as we can, tolerate as much as fits into our schedule, and we keep the carbs down. 语法解析

19:44

Once you start getting a regular period and a regular cycle, then that means we've done a good job tackling a lot of the PCOS issues. And then we move into supporting those sex hormones by breaking down the cycle week by week and talking about targeted fasting and nutritional strategies per week. So I hope that that helps. I'll say most women takes about four to six months to get their period back on a regular cadence. 语法解析

20:13

And then after that, we see a lot of people get pregnant in the six months following that. So I would be very optimistic. We have an amazing person on our team. She's actually just taking some time off for personal reasons, Dr. Nadia Pataguana. We called her Baby Whisperer. In about a year, a lot of women got pregnant working with her. She'll be back doing some coaching in the fall, a unique program that we're going to be launching in the fall. But we have an incredible, 语法解析

20:42

credible team that's fully able to support you if you're in this journey, you're not alone. You'll find a lot of community members that are trying to conceive and tackle PCOS and get regular cycles as well. So the Fastly Method, we're a great tool for you, my friend. And I want to give you all the hope in the world. I'm 14 years old. 语法解析

21:01

I remember a doctor telling my parents that I probably wouldn't be able to have kids. And I'm a 40-year-old mom to a really wild, wild 17-month-old healthy baby boy. So there's a lot of hope. Even though I didn't have to do IVF for infertility, I had to do it to bank embryos because of my past fertility issues in my 20s and teens. 语法解析

21:25

Science is super cool. So between lifestyle and science, I wish you the best of luck. I think there's a lot to be positive about. 语法解析

21:33

All right, the next question is from Miki from the Netherlands. Miki is asking, can you wreck your thyroid by fasting too much? Or is this not true? And can you heal it with fasting? Mine was subclinical hypothyroidism, but returned to normal when I stopped fasting without meds. I am back to alternate day fasting now because I love fasting so much. 语法解析

21:58

This is a big thing to unpack, but in general fasting is perfectly fine. You just have to do what you can tolerate. So we would want to look into one. Why do you have subclinical hypothyroidism? Is it because you have reverse T3 hypothyroidism? 语法解析

22:16

If that's the case, we would begin your fast after breakfast. This actually helps prevent the conversion of free T4 into reverse T3, driving it into the form of free T3 and sort of course correcting some of that subclinical hypothyroidism just by changing the meal timing. And then we would start our fast at breakfast and we would end it at breakfast the next day and we would just see how the body was doing. 语法解析

22:42

Often that helps in those cases of say reverse T3 hypothyroidism. When someone says that thyroid function has gotten worse while fasting, are you checking your thyroid levels while you are fasting? We never ever ever want to do hormone blood work or lipid blood work while we are fasting. The numbers are all going to be temporarily thrown off. 语法解析

23:10

So people will be halfway through a 42 hour fast or 48 hour fast or they'll be three days into a fast and they'll go get blood work done. And this blood work is not going to be representative of your hormone levels at all. The advice I give for hormones, so when anyone that I'm working with at The Fasting Method is to not fast for more than 14 hours a day for two to three days before doing any hormones. 语法解析

23:36

Whether that's thyroid hormones, whether that's sex hormones, we want to stop fasting for at least two days. For lipids, at least three days. And most people are doing all these at the same time, so it's three days. I always tell people, book your labs on Monday, eat Friday, Saturday, Sunday. Then Sunday evening, you can begin your fast and you can launch into a 24, 42, 48, 50, 语法解析

24:02

Three day fast, whatever at that point, because you're going to do your labs the following morning at 12 to 14 hours fasted. And that is the best time. So sometimes people look at their labs and like deepen into these therapeutic fasts and that they think that the numbers are not ideal. They're not going to be ideal. Lots going on in the body when you're fasting. So you do want to sort of stabilize a norm here and then having your levels checked. 语法解析

24:31

So if you came into a consultation or were in one of our community groups, that would be like the very first thing that I ask since you are checking your labs in the morning without medications. Were you fasting and how fasted were you? How long had you stopped fasting before doing these particular labs? There are instances, a lot of my colleagues in the low carb space do believe that a 语法解析

24:56

Fasting helps lower inflammation in the body and it's cellular inflammation that causes subclinical hypothyroidism. 语法解析

25:03

And that when that cellular inflammation is reduced, then the subclinical hypothyroidism goes away. So I actually have a lot of colleagues in the low carb space that won't even bother trying to treat subclinical hypothyroidism with any type of medication, especially if it's not too far off because the fasting will lower that inflammation, improving and correcting this issue. Dr. Fung and I also have a Facebook group. It's a free community. It's like the wild, wild west, to be honest. 语法解析

25:32

I spent a lot of time in our community forum, but every now and then I perused the Facebook group and I saw one woman report that it had actually reversed her hypothyroidism over time as well. We want to address any nutrient deficiencies. We want to make sure that the adrenals are in good shape. We want to make sure we know what's causing that subclinical hypothyroidism in the first place. 语法解析

25:54

You know, maybe it's iron, maybe it's selenium, maybe it's iodine, maybe it's the cortisol. So there's all these little things that we can look at and that we can easily address either through food or through some lifestyle modifications. Then we are able to help further support the thyroid and carry on with ADF. 语法解析

26:14

So those are things to take a look at. I would make sure you get some blood work done, know your morning cortisol. That's best to do with a saliva test or a urine test though over a 24-hour period. But get some selenium, iodine, and iron panel checked in the morning too. Get your reverse T3 levels checked as well so we have a better idea as to what is the cause of the subclinical hypothyroidism. 语法解析

26:40

And then, yeah, just be mindful of when you are doing your blood work. The last question for today's Q&amp;A is from Susie in South Carolina. Susie says, I've been on a night shift schedule at the hospital for the last 30 years, working 7 p.m. to 7 a.m. I love to know the ins and outs, stay as healthy as possible on nights, and the best way to fast with that schedule. 语法解析

27:05

Hospital is someone who spent most of her life working in a hospital or just in a hospital for family reasons. They're like the worst places to eat. So if you are going to eat, bringing foods that you can have. So doing meal prep, meal planning in advance. 语法解析

27:24

As someone who's worked in a hospital, sometimes having things on hand just in case, a dozen hard-boiled eggs, a pound of cooked chicken wings, some bacon, keeping a small bag of avocados around, a bottle of olive oil to go along with those avocados. Those are all things that I always just kept around in our staff room. 语法解析

27:46

So I would have something if I needed to that would help me stay away from some of the temptation that's there, especially during those really long and stressful days when the fasting is not necessarily going to happen. 语法解析

28:00

So having good, healthy food to revert back to more of these fat fasting style foods can be really good just to help you stay on track. And then, of course, doing as much meal prep as you can. So you're bringing any of your particular meals that you would eat during that time. 语法解析

28:19

Usually on an eating day, we would eat two meals. You'd have one at home before leaving. I imagine you would eat quote unquote dinner, which would be more like your breakfast before you leave for the 7 p.m. start of the shift. And then you would just eat once. So making sure that before you do go, that you prep something, even if it's just a duplicate of what you've eaten right before you've gone to work. 语法解析

28:41

and you've just made extra. That's what I found a lot of nurses and other healthcare practitioners do that work night shifts. They tend to have a bigger meal with their family before they leave to go to work. And what they bring for their next meal is just extra from that particular meal. And that's okay to do as long as you have enough variety in your diet throughout the week. 语法解析

29:02

So if you have something like steak and Brussels sprouts at home for dinner, then you can bring it for your lunchtime at work as well. You can just make an extra steak, make extra Brussels sprouts, bring whatever extra leftovers you have from that meal. And that's one of the easiest things to do. It can be a little monotonous, but you just got to make sure you're adding in enough variety throughout the week. And most people find that to be very sustainable. 语法解析

29:29

Now you get off work at 7am, I imagine you don't go to bed right away and if you are going to eat, if you are going to have your meal then, your second meal then, that's okay to do. You can have your second meal then. You just want to make sure that the time before your last meal and going to bed 语法解析

29:49

the window is at least three hours optimal would be four so if you can eat before you go to work and then once you're at work and then that way you're not eating at seven o'clock in the morning that would probably be the most ideal for this particular night shift schedule all right everyone thank you so much for sending in such amazing questions we'll be back next week with another episode bye for now and happy fasting 语法解析

</markdown>

Edit:2025.04.11<markdown>

@Megan Ramos : 在36或42小时禁食后，进食日不感到饥饿是因为身体在燃烧脂肪。如果身体在燃烧脂肪且不感到饥饿，可以考虑将禁食时间延长至每周两次48小时。一种48小时禁食的安排是：周日午餐和晚餐后开始禁食，直到周二晚餐；周三午餐和晚餐后禁食，直到周五晚餐；然后在周六和周日正常进食。48小时禁食通常非常有效，可以保持新陈代谢高速运转，并帮助燃烧脂肪，实现目标。每天进行24小时禁食不如每周进行两次48小时禁食。

关于间歇乏食的疑问时，有人在完成36或42小时乏食后，在进食日并不感到饥饿。这并非身体出了问题，恰恰相反，这说明身体正高效地燃烧脂肪，成为一台名副其实的“脂肪燃烧机器”。

这种情况下，无需强迫自己进食，也不必费尽心思在少量食物中塞满脂肪和蛋白质。除非存在严重的营养缺乏，否则，是时候将乏食时间延长至每周两次48小时了。

建议一种48小时乏食的安排：

• 周日: 午餐和晚餐后开始乏食。
• 周一至周二: 乏食。
• 周二: 晚餐后结束乏食。
• 周三: 午餐和晚餐正常进食。
• 周三至周五: 乏食。
• 周五: 晚餐后结束乏食。
• 周六和周日: 正常进食。

如此循环往复。 如果尝试过36小时乏食，发现三餐分量太少；或者尝试过42小时乏食，仍然难以完成两餐，那么48小时乏食通常能有效解决这个问题。能保持代谢高速运转，持续燃烧脂肪，帮助更有效地达成目标。

许多人会误以为每天进行24小时乏食更好，但事实并非如此。每周两次48小时乏食比每天24小时乏食更有效。 盲目缩短乏食时间，反而可能导致饮食紊乱，影响乏食效果。

关于早餐和多囊卵巢综合征（PCOS）：

一些文章建议PCOS患者不要跳过早餐，以平衡血糖。但如果早餐妨碍乏食计划，该如何选择？

通常情况下，只有在以下几种情况下才建议吃早餐：

• 高晨皮质醇水平: 如果早晨皮质醇水平过高（可以通过唾液或尿液检测），早餐可以帮助降低皮质醇水平。
• 肾上腺功能不全: 如果存在肾上腺功能不全，早餐有助于维持皮质醇储备。
• 反向T3甲状腺功能减退: 这种情况也与皮质醇模式密切相关，早餐有助于改善症状。

其他情况下，不必强求吃早餐。 对于PCOS患者，更重要的是先解决胰岛素抵抗问题，再优化其他激素水平。

关于延长乏食、自噬和松弛皮肤：

一些人担心延长乏食会造成体重下降过多，导致皮肤松弛。 事实上，36小时或更长时间的乏食有助于皮肤紧致，但效果取决于之前的减重方式。

建议进行DEXA身体成分扫描或使用家用身体成分秤，了解身体成分比例（脂肪、骨骼、肌肉）。 如果脂肪比例较高，则无需过度担心减重，可以专注于通过力量训练增加肌肉量和骨密度。如果脂肪比例较低，则可以在进食日增加蛋白质和脂肪摄入量（15-30克蛋白质和脂肪），并进行力量训练，促进健康增重。

关于42小时乏食无效的情况：

如果进行42小时乏食（每周2-3次）没有效果，需要检查以下几点：

• 进食日的饮食习惯: 避免零食和频繁进食，确保在进食窗口内只吃正餐。
• 蛋白质摄入量: 确保进食日每天摄入足够的蛋白质（约80克，两餐分配）。
• 脂肪摄入量: 控制脂肪摄入量，避免过量食用奶制品等高脂肪食物。
• 其他因素: 检查是否存在营养缺乏、激素失衡等问题。

总而言之，根据自身情况调整乏食时间和饮食习惯至关重要。 持续监测身体状况，并根据需要寻求专业人士的建议，才能更好地实现健康减重和身体优化。

◉

00:23 在禁食36或42小时后，你在进食日不感到饥饿，是因为你的身体正在燃烧大量脂肪，这是你想要的结果。

◉

00:46 今天我将回答大家关于禁食的问题，包括如何判断当前的禁食方案不再有效，是否需要延长禁食时间至48小时，以及是否应该跳过早餐。

◉

01:27 节食史不会破坏你的身体。

◉

02:08 如果身体在燃烧脂肪且不感到饥饿，可以考虑将禁食时间延长至每周两次48小时。

◉

02:23 除非有特定的营养不足问题需要解决，否则不必强迫自己在午餐时进食。

◉

02:39 如果没有营养不足的问题，可以将目前的2次42小时禁食延长至2次48小时。

◉

03:07 一种48小时禁食的安排是：周日午餐和晚餐后开始禁食，直到周二晚餐；周三午餐和晚餐后禁食，直到周五晚餐；然后在周六和周日正常进食。

◉

03:30 48小时禁食通常非常有效，可以保持新陈代谢高速运转，并帮助燃烧脂肪，实现目标。

◉

03:48 许多人最终陷入每日一餐的境地，因为他们不总是感到饥饿，饮食变得混乱，禁食也变得困难。

◉

04:17 每天进行24小时禁食不如每周进行两次48小时禁食。

◉

04:45 只有在少数情况下，我才建议早上吃早餐。

◉

05:10 如果早晨皮质醇水平较高，通常在醒来后的30到60分钟内吃一顿富含蛋白质的早餐，以降低皮质醇水平。

◉

05:59 多囊卵巢综合征（PCOS）患者由于孕酮水平较低，通常睡眠质量较差，因此了解皮质醇水平非常重要。

◉

06:25 早上进行皮质醇血液测试几乎没有用处，应该通过24小时的唾液或尿液测试来观察皮质醇水平。

◉

07:13 如果某人患有肾上腺功能不全，即使早上的皮质醇水平还可以，但一天中剩余时间的水平过低，我们也希望保持一定的皮质醇储备，因此建议在早上吃早餐。

◉

07:39 如果患有反向T3型甲状腺功能减退症，也应确保在醒来后的第一个小时内吃早餐。

◉

08:10 如果有人在周期的后半段积极尝试怀孕，我喜欢在周期中的最后一周引入早餐。

◉

08:38 如果你患有多囊卵巢综合征（PCOS）并且有胰岛素抵抗，我们首先要治疗胰岛素抵抗，然后优化其他水平。

◉

09:04 一旦我们开始有规律的月经周期，多囊卵巢综合征的症状消失，血液检查正常，影像学检查（如腹部超声或CT扫描）良好，我们就会采取更优化的方法，在周期的特定部分包括早餐。

◉

09:44 皮肤通常在36小时或更长时间的禁食后开始收紧，但这取决于体重是如何减轻的。

◉

10:11 当我们有松弛的皮肤时，我们会开始循环进行一些更长时间的禁食，例如36小时或更长时间。

◉

10:30 首先，进行DEXA身体成分扫描或使用家用身体成分秤，以了解身体成分。

◉

10:54 如果身体成分的结果让你感到惊讶，我们可能不必太担心改变饮食，可以继续进行长时间的禁食，并引入一些力量训练，以帮助你增加一些健康的瘦体重。

◉

11:13 体重秤上的数字只是告诉我们总数，我们需要知道这个总数意味着什么，有多少脂肪、骨骼和肌肉。

◉

11:26 通过力量训练或体重训练，可以同时优化骨密度和肌肉质量，这是两全其美的方法。

◉

11:44 如果你的体脂含量不高，并且想进行一些用于自噬的治疗性禁食，那么我们会在你的进食日增加15到30克额外的蛋白质和脂肪。

◉

12:03 我们通常从15克蛋白质和15克膳食脂肪开始，观察体重减轻的情况，然后增加到30克左右。

◉

12:03 增加健康的构建块，这样当你进行力量训练以增加健康体重时，你就有肌肉修复所需的构建块。

◉

12:32 我们的目标是增加健康的体重，这就是我们过去与体脂含量非常少并希望因各种原因进行治疗性禁食的专业运动员合作时所采取的方法。

◉

12:59 最好每周进行三次治疗性禁食，如果某周只能进行两次42小时的禁食，我仍然会至少增加一次24小时的禁食，以确保一周内有三次禁食。

◉

13:26 首先，我们会快速扫描进食日和禁食日的情况，然后再进行更深入的实验室检查。

◉

13:26 在进食日，我们应该只吃正餐，避免零食和频繁进食。

◉

13:46 许多人会在进食日进行16或18小时的禁食，然后在6到8小时的进食窗口内频繁进食。

◉

14:14 即使是健康的低碳或生酮食物，甚至只是肉类，我们也不应该这样做，因为即使胰岛素水平稍微升高，持续不断地刺激胰岛素也会导致胰岛素抵抗。

◉

14:42 即使持续少量地产生胰岛素也会导致胰岛素抵抗，重要的是进食的频率而不是食物的量。

◉

14:42 在16或18小时的禁食日，我们是否可以改善时间限制饮食？我们是只吃午餐和晚餐，还是在两餐之间吃东西？

◉

15:07 我们需要摄入足够的蛋白质，蛋白质的需求量因人而异，取决于个人的活动量以及女性所处的荷尔蒙阶段。

◉

15:23 大多数人在想要减肥时，每天两餐的目标是摄入约80克蛋白质。

◉

15:49 随着我们接近维持阶段，可能需要高达100甚至120克的蛋白质，但通常是两餐日约80克，即每餐40克。

◉

15:49 我们不希望每餐吃超过40到50克蛋白质，因为过量的蛋白质会转化为葡萄糖，导致糖异生。

◉

16:14 许多人在转向低碳或生酮饮食时，会移除淀粉和谷物，但不确定应该吃什么来填饱肚子，所以最终会吃奶酪、坚果和种子。

◉

16:34 奶酪、坚果和种子可以作为配菜，而不是作为主菜。

◉

16:34 如果你是一个杂食动物，那么你的盘子应该有三分之一是动物蛋白，三分之二是纤维蔬菜。

◉

16:50 有些人没有控制奶酪和坚果的量，也没有吃其他食物来填饱肚子，所以总是想吃东西，永远不会感到饱腹。

◉

17:04 食肉动物通常在一餐中摄入多种脂肪和蛋白质来源，以确保获得足够的食物。

◉

17:23 对于素食者，我们确保每餐都有足够的蛋白质和脂肪，并确保通过植物性食物覆盖所有必需氨基酸。

◉

17:52 在禁食日，我们需要检查你摄入的浓奶油量，并确保你正在测量它。

◉

18:11 我们需要减少全天摄入的脂肪量，并检查你是否因为需要或想要而使用禁食训练轮。

◉

18:26 我们会尽量减少禁食日的“想要”，并尽可能地满足“需要”。

◉

18:42 如果这些方法不起作用，我们会开始进行实验室检查，以查看是否存在需要解决的营养不足或需要解决的额外激素失衡。

◉

18:42 女性一生中的常见时期是围绝经期。

◉

19:00 在围绝经期，我们需要特别注意营养储备，尤其是铁储备，并确保它们达到标准水平。

◉

19:00 对于处于围绝经期的女性，我们通常将禁食时间限制在36小时左右，以确保她们摄入足够的蛋白质。

◉

19:25 在围绝经期，我们尝试每天三餐摄入约35克蛋白质，以帮助平衡激素。

◉

19:25 在围绝经期，我们通常在早上吃早餐，以帮助支持甲状腺功能、肾上腺功能，并平衡一些激素。

◉

19:53 围绝经期是女性一生中最具破坏性的时期之一，因此我们非常关注每周三次的36小时禁食，这样我们就可以通过三餐来分配蛋白质。

◉

19:53 我们会采取这些策略，查看实验室检查结果，并根据实验室检查结果，指导你去看哪些医生（如果有的话），或者是否有任何营养方面的问题可以帮助你调整。

00:00

The reason why you're not feeling hungry on your eating days after a 36 or 42 hour fast is because your body's actually burning a lot of fat. Yes, you are a fat burning machine. It's doing exactly what you want it to do. 语法解析

00:23

Hi everyone, it's Megan Ramos here with another episode of the Fasting Method podcast. Today I'm going to answer your questions. We're going to cover topics such as how you know when your current fasting protocol is no longer working for you. Do you need to extend things to 48 hours? Should you skip breakfast or should it be the most important meal of the day? 语法解析

00:46

Now let's dive on in. The first question comes from Aulina. On eating days, I almost always feel very full. I try to make my meal portions smaller, but I still feel full. I don't seem to fill any hunger cues on my eating days nor fasting days. Have 20 years of dieting broken my body? My usual fasting protocol is 336s or lately 242s. 语法解析

01:14

This is a fantastic question. And my friend, and for all of you out there who I have no doubt are in the same boat as our good friend here, you are not broken from your history of dieting. 语法解析

01:27

The reason why you're not feeling hungry on your eating days after a 36 or 42 hour fast is because your body's actually burning a lot of fat. Yes, you are a fat burning machine. It's doing exactly what you want it to do. 语法解析

01:45

But because your body is burning so much fat and providing it with so much of the fuel that it needs, the hunger just isn't there. It's not there at all and it can feel really difficult to try to push through and eat multiple meals on those eating days. This is when it's time to graduate into doing that 48 hour fast twice a week. 语法解析

02:08

You don't have to force yourself to eat that lunch. You don't have to try to get creative with jam packing a lot of fat calories and protein into a small meal, not unless you have certain nutrient deficiencies that you're tackling. 语法解析

02:23

So if you do have certain nutrient deficiencies that are becoming serious issues, then yes, you might need to eat a little bit more and fast a little bit less. But if that's not the issue, then extend those 242s that you're doing to 248s. 语法解析

02:39

So that would look like on Sundays, you have lunch, you have dinner, you begin your fast and you fast until Tuesday dinner. Then you eat Wednesday lunch and dinner. You fast from Wednesday dinner until Friday dinner. And then you eat Saturday and Sunday. Again, on repeat, 248s. It's okay. If you've got the body fat to burn and you're burning it and you're not feeling hungry, then it's time to graduate to 248s. 语法解析

03:07

And again, if you're doing those 336s and you found those three meals to be too small, then you go to the 42s and try to do two meals. That's what you've done. Still can't get that meal in just quite right. Then you go to 48s. The 48s are often really effective. They keep your metabolism running high and they'll keep you burning fat. They'll keep you working towards your goals. We're 语法解析

03:30

Where a lot of people struggle here is they end up falling into a one meal a day situation. You know, they can't necessarily do the 42s because they're not necessarily hungry all the time. The diet then gets kind of messy on the eating days. They end up struggling a bit with the fasting. 语法解析

03:48

Then they end up going to 24s and just think, oh, I'm going to do daily 24s and that will be so much better. It is not better, my friend. It is not better at all. It's better to go back to the 48s twice a week. The next question says, I read on some of the polycystic ovary syndrome or PCOS blogs that you shouldn't skip breakfast because it balances your blood sugar. But I find it harder to meet my fasting goals when I eat breakfast. 语法解析

04:17

Is this reference to early time-restricted eating? Or is it better to meet the daily fasting goal or longer fast or to consume the meals earlier in the day? All right, my friend, there are only a couple of instances where I say we should really have breakfast in the morning. Number one, your morning cortisol levels are quite high. They're on the higher side of things. Sometimes just having a higher morning glucose will tip you off on this. 语法解析

04:45

You can do a saliva test or you could do a urine test that measures your saliva or urine over the period of 24 hours so you can see your cortisol curve. If our cortisol levels are elevated in the morning, then we do want to eat breakfast. We do want to eat a protein rich breakfast usually within that first 30 to 60 minutes of waking to blunt the cortisol levels. 语法解析

05:10

So we can have dysregulated cortisol levels for a whole variety of reasons. I'm experiencing it personally right now because my son is going through a lot of teething and he's up all night. I don't remember the last time I slept. I know it was sometime in 2024. I don't think I've slept yet in 2025. I'm sure I probably won't have slept by the time this episode comes out. 语法解析

05:33

So my circadian rhythm's all off, my cortisol's all off as a result of that. So we have these disturbances, we could have stress going on, or again, just sort of your regular circadian rhythm stuff being a bit off. PCOS individuals tend to struggle with sleep quite a bit because of their lower progesterone levels. So it's always good to know where that cortisol is. 语法解析

05:59

Our cortisol levels are going to be the highest they are throughout the day in the morning, but are they a healthy high or are they an abnormally healthy high? So this is where doing that 24-hour urine or saliva test can be really helpful. Morning cortisol blood tests are virtually useless. So you want to look at it over 24 hours with a saliva test or a urine test. The urine one is called the Dutch test by Precision Analytics. 语法解析

06:25

They also do a saliva. That one, I believe in most states you can order yourself. I'm not so sure about ordering saliva independently. Many labs do them like Genova. Any healthcare naturopath or integrative functional doctor will be able to order those particular tests for you as well. 语法解析

06:45

And I do believe you can use FSA or HSA in the United States to purchase the Dutch test for precision analytica. That's the one I used recently to learn my cortisol was so high. So that's usually what we're looking to tackle. This can further be an issue in individuals who are struggling with HPA axis dysfunction or adrenal insufficiency. If someone's struggling with adrenal insufficiency, 语法解析

07:13

meaning they sort of have these chronically lower levels of cortisol, even if their level is still okay in the morning, but it's too low throughout the rest of the day. We do want to maintain some cortisol reserves. So if you have adrenal insufficiency, then we include breakfast in the morning. So those are two instances. The third one would be if you have reverse T3 hypothyroidism. That's also largely connected to cortisol patterns. 语法解析

07:39

But if you had reverse T3 hypothyroidism, then we would want you to make sure that you're having breakfast within that first hour of waking. 语法解析

07:47

So those are really the three big ones. If someone is actively trying to conceive during the second half of the cycle, I do like to introduce breakfast, especially that last week of the cycle. But outside of that and those scenarios there, then you don't necessarily need to skip breakfast. 语法解析

08:10

With the people who are saying this, the rule of thought is that if you eat, you'll lower your cortisol levels, which will then lower glucose levels. But if you have PCOS and you have a lot of insulin resistance, we do want to treat that insulin resistance first and then work on optimizing the rest of the levels side of that. And if there are things that are driving your elevated cortisol, taking some supportive herbs or supplements to help with that, 语法解析

08:38

that as well as addressing lifestyle factors can go a long way. So we would do that simultaneously with treating the insulin resistance. And once we start having regular cycles and the symptoms of PCOS are gone, we're getting normal blood work. Imaging looks well like an abdominal ultrasound or a CT scan. And then we would move into doing something a little bit more optimized where we would include breakfast during certain parts of our cycle. 语法解析

09:04

The next question says, how do I not lose more weight with extended fasting for autophagy? I am 71 and I've lost 44 pounds over an eight month period. One pound most weeks, never more. Congratulations. That's a really cool amount of weight loss over an eight month period, my friend. And then goes in to say, I have loose skin on my arms, bellies and legs. I'm looking older than I ever have. I will be doing 24 hour fasts to maintain my weight loss. 语法解析

09:34

We see skin start to tighten on fasts that are 36 hours or longer, but it sort of depends on how that weight was lost. 语法解析

09:44

Now from Anne's question, it does sound like she lost that 44 pounds over eight months doing fasting. So congratulations, Anne. When we do have loose skin, we would then start to cycle in some of these longer fasts, so 36 hours or longer, which is why Anne is asking and saying that she wants to do some extended fasts for autophagy, but not lose weight. So Anne, one of the things I would do 语法解析

10:11

first is go get a DEXA body composition scan or get one of those body composition scales at home. There's the Omron, there's the Renpho, there's an InBody one that you can buy for your home. I have the InBody and I have the Omron. A bunch of coaches on my team have the Renpho and really like it. They're all good. 语法解析

10:30

Let's see where your body composition is so we know just how much weight that there is to lose. And if their body composition ends up surprising you a little bit, then we might not necessarily have to worry so much about modifying things on our eating days. We can carry on with extended fasting and we can introduce some strength training to help you put on some lean and healthy mass. 语法解析

10:54

The weight on the scale just tells us the total number. We want to know what that total number means, how much fat mass, how much bone mass, how much muscle mass is there. Are there any areas for improvement in any of these categories? If there ends up being a surprising amount of fat mass, then we don't have to necessarily worry about 语法解析

11:13

losing that fat mass we would focus on gaining some healthy weight by optimizing our bone mass density and our muscle mass and the best way to do that two birds with one stone is through strength training or body weight training 语法解析

11:26

Now, if you are to do that body composition analysis and you don't have very much body fat at all and you want to do some of these therapeutic fasts for autophagy, then what we would do is we would add in anywhere from 15 to 30 extra grams of protein on your eating days as well as fat. 语法解析

11:44

Usually for most people, we start off with 15 grams of protein, 15 grams of dietary fat. We just kind of see how their weight loss efforts shift and then we increase it upwards to about 30 grams. So adding in healthy building blocks. So when you're doing that strength training to help you put on healthy weight, 语法解析

12:03

that you do have the building blocks there that you need in order to do so once the muscle starts to repair. So we do add in the extra protein. We do add in that extra fat. The goal is to gain healthy weight. So that's the approach that we've taken when we've worked with professional athletes in the past who have very little body fat and are looking to do therapeutic fasting for various reasons. And our last question of the day comes from Sylvia in California. 语法解析

12:32

Sylvia says, “I started doing 42 hour fasts, sometimes three a week, sometimes two to switch it up. I'm not losing weight or inches. What am I doing wrong?” Well, I love here that Cynthia is checking both weight and inches because sometimes that scale can be deceiving. So it's really about how are your clothes fitting? How are those inches moving? If you're not losing inches, then there's a bit of plateau going. 语法解析

12:59

Now, it's best to do three therapeutic fasts a week. So on those weeks that you can only do two 42s, I would still throw in at least a 24 to get three of them in a week. There are things that we do a quick scan on eating days and then fasting days before we dive into some more of the labs. The first thing we do is look at eating days. This is usually where we can make the most progress and get the weight coming off. 语法解析

13:26

So on our eating days, are we snacking and grazing or are we just having meals? A lot of people will do something like 16 or 18 hours of fasting on their eating days and then they'll have the six to eight hour eating window, which they eat often and frequently through the six to eight hours. 语法解析

13:46

That's bad news. That's grazing. We don't want to graze. We don't want to snack. Even if it's on healthy, low-carb or ketogenic foods, even if it's just meat, we don't want to do it because even having our insulin levels go up a little bit, micro amounts, constantly, nonstop, that constant stimulus of insulin for hours causes insulin resistance. Everybody thinks they need to eat a loaf of bread or a bowl of pasta or something that's going to cause their blood sugar levels to skyrocket. That's not the case. 语法解析

14:14

Even producing a little bit of insulin consistently over hours can cause insulin resistance itself. It's not always about the volume of insulin of food that you eat causes you to produce. It is the frequency at which you eat throughout the day. So are there opportunities to tidy up the time-restricted eating on those 16, 18-hour fast days? Are we having lunch? Are we having dinner? Are we not having anything in between? 语法解析

14:42

So that's number one. Number two, are we getting in enough protein? Now, protein needs are going to vary greatly depending on the individual and their activities and for women to where they are in their hormonal stages of their journey. But are we getting in enough protein? I'll tell you, when I usually ask people to keep a food diary and track their macros, it's because I want to see this. And more often than not, 语法解析

15:07

People are eating one meals worth of protein over the span of two meals. So then we adjust the protein. Most of us want to be sort of targeting around 80 grams of protein a day on a two meal day when we're looking to lose weight. 语法解析

15:23

Of course that changes as we approach maintenance. We might need upwards to about 100 and sometimes 120 grams, but usually it's around 80 grams over two meal days. So 40 and 40 grams. We don't want to eat much more than 40, 50 grams per meal because the excess will get converted to glucose at that particular time and cause gluconeogenesis. But we do want to make sure that we are getting in adequate protein on our eating days. 语法解析

15:49

So, making sure we're not snacking and grazing, making sure we're getting an adequate protein. A lot of people too, when they switch to a low carb or ketogenic diet, is they remove starches, they remove grains, and they're not quite sure what to fill them up on. So they end up filling up on cheese and nuts and seeds. Now cheese and nuts and seeds are fine to have if they agree with your system, but you need to think about having them in garnish size amounts. 语法解析

16:14

You've got to think, you know, about one third of your plate if you're an omnivore, which most people are omnivores. One third of your plate needs to be animal protein. Two thirds of your plate need to be fibrous vegetables. And then you can use some cheese. You can use some nuts and seeds as garnishes on those things that are on the plate. 语法解析

16:34

So you think of them as like a seasoning ingredient. They're not a side dish on their own. Sometimes people do keep the volume of cheese and nuts down very much, but they don't fill up on anything else. And then they're kind of constantly looking to eat, never really feeling quite satiated. And, and, 语法解析

16:50

that ends up throwing them off. So are there things that we can fix on the eating days? For carnivores, we usually like them to have a couple different sources of fat, a couple different sources of protein at a meal to make sure we're getting in adequate food. 语法解析

17:04

For plant-based individuals, we really hunker down, make sure there's adequate protein and fat at each particular meal, and that we're covering all of our amino acid bases with the plant-based individuals. So those are some of the alternate diets that we often work a lot with and some of the hiccups and fixes for those. 语法解析

17:23

Now on your fasting days, how much heavy cream are you having? If you're even having any, are you measuring it? A lot of people think they can ballpark it just by pouring and that never goes well. And we had one share community recently that when they measured it, they were having almost a cup worth throughout the day in their tea. So, you know, this is something that we want to scale back down. I know Jason and I for years have said three tablespoons, three tablespoons. 语法解析

17:52

Honestly, it should be more like three teaspoons. So we really want to cut back on the amount of fat that we're having throughout the day. We need to take a look at the use of fasting training wheels. Are you using them because you can't have them and you want them on your fasting days? Are you using them because you need to use them? 语法解析

18:11

So we look to see what improvements that we can make, if we can adjust anything, scale it down, if we need something versus if we just want to have something and trying to remove the wants as much as possible from our fasting days. 语法解析

18:26

If those things are not working, then we start to look at the labs. We start to look to see if there's any deficiencies that we need to tackle, if there are any additional hormonal imbalances that we need to tackle. A common period in a woman's life is during perimenopause. 语法解析

18:42

When sometimes we do need to be very mindful about nutrient stores, especially iron stores, and making sure that those are all up to level. And with women who are going through perimenopause, in general, we cap it about 36 hours just to make sure that they are getting in protein. 语法解析

19:00

because this particular demographic usually means about 100 grams of protein, even if they have quite a bit of weight loss to lose. And we try to get about 35 grams per meal or the span of three meals to help balance hormones. We do eat breakfast in the morning a lot in perimenopause just to sort of help support thyroid functions, to support adrenal function, to get some of those hormones in balance. 语法解析

19:25

Perimenopause is one of the most destructive times in a woman's life. So we do focus a lot on 36 hour fasts, three times a week. So we can get in those three meals and spread that protein out over the course of the day. We go through those strategies, we take a look at the labs, we try to point you in direction too from the labs of what practitioners you might need to see, if any, or if there's anything nutritional wise that stands out to us that we can help you adjust. 语法解析

19:53

But taking a look at those particular things can often really help get the fat loss going. All right, everyone. Thank you so much for joining us for another episode of the Fasting Method Podcast. We'll be back next week. Bye for now and happy fasting. 语法解析

</markdown>

Edit:2025.05.16<markdown>

 

00:23 大家好，我是梅根·拉莫斯， 今天我将回答你们的问题。我们将讨论诸如如何知道当前的乏食方案对你来说不再有效，你是否需要将乏食时间延长至48小时，以及是否应该跳过早餐等话题。

00:46 现在让我们深入探讨。第一个问题来自阿乌利娜：在进食日，我几乎总是感到非常饱。我尝试将餐量做得更小，但我仍然感到饱。在进食日和乏食日，我似乎没有任何饥饿信号。20年的节食是否破坏了身体？我的常规乏食方案是336方案或者最近的242方案。

01:14 这是一个很好的问题。我的朋友，以及所有和我这里的好朋友一样，毫无疑问你们也在经历同样的事情，你们并没有因为节食的历史而身体受损。

◉ 节食史不会破坏你的身体。

01:27 在乏食36或42小时后的进食日你感觉不到饥饿的原因是，你的身体实际上正在燃烧大量脂肪。是的，你是一台脂肪燃烧机器。它正在做你希望它做的事情。

01:45

但是，因为你的身体正在燃烧大量脂肪，为其提供了所需的燃料，所以实际上并不感到饥饿。完全没有这种感觉，在这些进食日尝试坚持吃多餐可能会感到非常困难。这时候就到了每周进行两次48小时乏食的时候了。

◉ 如果身体在燃烧脂肪且不感到饥饿，可以考虑将乏食时间延长至每周两次48小时。

02:08

你不必强迫自己吃那顿午餐。除非你有特定的营养缺乏问题需要解决，否则不必试图用果酱把大量脂肪热量和蛋白质塞进一顿小餐里。

◉ 除非有特定的营养不足问题需要解决，否则不必强迫自己在午餐时进食。

02:23

所以，如果你确实有某些营养缺乏问题变得严重，那么是的，你可能需要多吃一点，少饿一会儿。但如果这不是问题所在，那么将你目前进行的2次42小时乏食延长至2次48小时。

◉ 如果没有营养不足的问题，可以将目前的2次42小时乏食延长至2次48小时。

02:39

那么这看起来会是这样的：周日吃午餐和晚餐，然后开始乏食直到周二晚餐；周三吃午餐和晚餐后乏食，直到周五晚餐；然后在周六和周日正常进食。再次重复，2次48小时。没问题的。如果你有足够的体脂可以燃烧，而且你正在燃烧它，而且你不感到饥饿，那么就到了升级到2次48小时的时候了。

◉ 一种48小时乏食的安排是：周日午餐和晚餐后开始乏食，直到周二晚餐；周三午餐和晚餐后乏食，直到周五晚餐；然后在周六和周日正常进食。

03:07

再次强调，如果你在做336乏食并且觉得三顿餐食太少，那就改为42乏食，尝试两顿餐食。这就是你正在做的事情。但仍然无法把那顿饭吃得很对劲。然后你尝试48乏食法。48乏食法通常非常有效。它能让你的新代谢保持高速运转，帮助你燃烧脂肪，并让你朝着目标前进。 

◉ 48小时乏食通常非常有效，可以保持代谢高速运转，并帮助燃烧脂肪，实现目标。 03:30

许多人在这里挣扎，因为他们最终陷入每天只吃一餐的境地。 他们不一定能做42乏食法，因为他们并不总是感到饥饿。这样一来，在进食的日子里，饮食会变得有些混乱。他们乏食时有些困难。

◉ 许多人最终陷入每日一餐的境地，因为他们不总是感到饥饿，饮食变得混乱，乏食也变得困难。 03:48

然后他们改为24小时乏食，心想，哦，我要进行每日24小时乏食，这样会好很多。朋友，这并不会更好。一点也不更好。每周两次回到48小时乏食会更好。下一个问题是：我在一些多囊卵巢综合症（PCOS）博客上读到，不应该跳过早餐，因为能平衡血糖。但当我吃早餐时，我发现达到乏食目标更难。

◉ 每天进行24小时乏食不如每周进行两次48小时乏食。 04:17

这是否指的是早限时进食？是更好地达到每日乏食目标还是更长时间的乏食，还是在一天中更早地摄入食物？好的，我的朋友，我只在少数几个情况下说我们应该早上一定要吃早餐。第一，你的早晨皮质醇水平相当高。处于偏高的状态。有时候只需早晨血糖较高就能提示你这一点。

◉ 只有在极少数情况下，我才建议早上吃早餐。

04:45

你可以做唾液测试，或者进行一项尿液测试，该测试可测量你在24小时内的唾液或尿液，以便你能看到你的皮质醇曲线。如果我们的早晨皮质醇水平升高，那么我们确实想吃早餐。我们通常想在醒来后的前30到60分钟内吃一顿富含蛋白质的早餐，以降低皮质醇水平。

◉ 如果早晨皮质醇水平较高，通常在醒来后的30到60分钟内吃一顿富含蛋白质的早餐，以降低皮质醇水平。

05:10

所以我们的皮质醇水平可能因各种原因而失调。我现在正亲身体验，因为我的儿子正在经历很多出牙期不适，他整夜未眠。我不记得上次睡觉是什么时候了。我知道是在2024年的某个时候。我认为我在2025年还没睡过觉。我确定在这个节目播出之前我可能还不会睡。

05:33

所以我的生物钟全乱了，皮质醇也因此受到影响。所以我们有这些干扰，可能是压力所致，或者仅仅是常规的生物钟有些紊乱。多囊卵巢综合症（PCOS）患者由于孕酮水平较低，通常睡眠质量较差，因此了解皮质醇水平非常重要。

05:59

我们的皮质醇水平在早晨达到全天最高，但这是健康的高还是异常地高呢？所以，此时进行24小时尿液或唾液检测会非常有帮助。早晨的皮质醇血液检测几乎没有用处。因此，你需要通过24小时的唾液或尿液检测来进行观察。尿液检测称为Precision Analytics的荷兰检测。

◉ 早晨进行皮质醇血液检测几乎没有用处，应该通过24小时的唾液或尿液测试来观察皮质醇水平。

他们也会做唾液检测。我相信在大多数州你可以自己订购。我不确定是否可以独立订购唾液检测。很多实验室像Genova一样提供此类服务。任何医疗自然疗法或综合功能医生都可以为你订购这些特定的检测。

。

我最近就是用这种测试发现自己皮质醇水平过高。通常这就是我们要解决的问题。对于患有下丘脑-垂体-肾上腺轴功能障碍或肾上腺功能不全的人来说，这可能进一步成为问题。如果有人患有肾上腺功能不全，即使早上的皮质醇水平还可以，但一天中剩余时间的水平过低，我们也希望保持一定的皮质醇储备，因此建议在早上吃早餐。

意味着他们的皮质醇水平长期偏低，即使早晨的水平仍然还可以，但整个白天都过低。我们确实想要保持一些皮质醇储备。所以如果你有肾上腺功能不全，那么我们在早上包括早餐。所以这是两个例子。第三个例子是如果你患有逆T3型甲状腺功能减退症。这也与皮质醇模式有很大关联。

◉ 如果你患有逆T3型甲状腺功能减退症，你也应确保在醒来后的第一个小时内吃早餐。 07:39

但如果你患有逆T3型甲状腺功能减退症，那么希望你确保在醒来后的第一个小时内吃早餐。

07:47

所以这确实是三个主要方面。如果有人在周期的后半段积极尝试怀孕，我喜欢在周期中的最后一周引入早餐。但除此之外，以及在其他情景下，那么你并不一定需要跳过早餐。

◉ 如果有人在周期的后半段积极尝试怀孕，我喜欢在周期中的最后一周引入早餐。 08:10

对于那些这样说的人，他们的想法是，如果你吃东西，你将降低你的皮质醇水平，这将进而降低血糖水平。但如果你患有多囊卵巢综合征并且有很多胰岛素抵抗，我们确实要先治疗胰岛素抵抗，然后再努力优化其余的水平。如果有因素导致你的皮质醇水平升高，服用一些支持性的草药或补充剂来帮助解决这一问题，

◉ 如果你患有多囊卵巢综合征（PCOS）并且有胰岛素抵抗，首先要治疗胰岛素抵抗，然后优化其他水平。 08:38

以及解决生活方式因素可以走很长的路。因此我们会同时进行治疗胰岛素抵抗和治疗。一旦开始有规律的月经周期，多囊卵巢综合征的症状消失，我们的血液检查结果正常。影像学检查看起来像是腹部超声或CT扫描。然后我们会转向做一些更加优化的事情，在月经周期中的某些时段我们会包含早餐。

◉ 一旦开始有规律的月经周期，多囊卵巢综合征的症状消失，血液检查正常，影像学检查（如腹部超声或CT扫描）良好，我们就会采取更优化的方法，在月经周期的特定部分包括早餐。

下一个问题是，我如何通过延长乏食来进行自噬而不减少更多体重？我今年71岁，在八个月的时间里减掉了44磅。大多数星期减掉一磅，从不超过。恭喜。我的朋友，这是八个月时间里非常酷的减重成果。然后又说，我的手臂、腹部和腿上有松垂的皮肤。我看起来比以前老多了。我会进行24小时的乏食来维持我的减重效果。

◉ 我们看到在36小时或更长时间的乏食后皮肤开始收紧，但这取决于体重是如何减轻的。

现在从安妮的问题来看，她似乎是在八个月的时间里通过乏食减掉了那44磅。所以恭喜你，安妮。当我们有松弛的皮肤时，我们会开始循环进行一些更长时间的乏食，比如36小时或更长时间，这就是为什么安妮在询问并说她想进行一些延长的乏食来进行自噬，但不想减重。所以安妮，我会做的其中一件事是

◉ 当我们有松弛的皮肤时，我们会开始循环进行一些更长时间的乏食，例如36小时或更长时间。

首先去进行双能X射线骨密度仪（DEXA）身体成分扫描，或者在家购买一台身体成分秤。

◉ 首先，通过DEXA身体成分扫描或使用家用身体成分秤来了解你的身体成分。 10:30

让我们看看你的身体成分如何，这样我们就知道还有多少重量需要减掉。如果他们的身体成分结果让你有些意外，那么我们可能不必太担心在进食日调整饮食。我们可以继续进行长时间乏食，并引入一些力量训练，帮助你增加一些健康肌肉。

◉ 如果身体成分的结果让你感到惊讶，我们可能不必太担心改变饮食，可以继续进行长时间的乏食，并引入一些力量训练，以帮助你增加一些健康的瘦体重。 10:54

体重秤上的数字只是告诉我们总数。我们需要知道这个总数意味着什么，有多少脂肪、骨骼和肌肉。在这些类别中是否有任何需要改进的地方？如果出现大量意外的脂肪质量，那么我们不必过于担心。

◉ 体重秤上的数字只是告诉我们总数，我们需要知道这个总数意味着什么，有多少脂肪、骨骼和肌肉。 11:13

为了减少脂肪质量，我们会专注于通过优化骨密度和肌肉质量来增加一些健康体重。一石二鸟的最佳方法是通过力量训练或体重训练。

◉ 通过力量训练或体重训练，可以同时优化骨密度和肌肉质量，这是两全其美的方法。 11:26

现在，如果你要进行身体成分分析，并且你几乎没有任何体脂，并且想要进行一些用于自噬的治疗性乏食，那么我们会做的是，在你的进食日额外增加15到30克的蛋白质以及脂肪。

◉ 如果你的体脂含量不高，并且想进行一些用于自噬的治疗性乏食，那么我们会在你的进食日增加15到30克额外的蛋白质和脂肪。 11:44

通常对于大多数人，我们一开始提供15克蛋白质和15克膳食脂肪。我们只是观察他们的体重减轻情况，然后将其增加到大约30克。所以增加健康的构建块。因此，当你进行力量训练以帮助增加健康体重时，

◉ 我们通常从15克蛋白质和15克膳食脂肪开始，观察体重减轻的情况，然后增加到30克左右。 12:03

你确实有需要的构建肌肉，以便一旦肌肉开始修复。所以我们确实增加了额外的蛋白质。我们确实增加了额外的脂肪。目标是增加健康体重。这就是我们过去与体脂含量非常少并希望因各种原因进行治疗性乏食的专业运动员合作时所采取的方法。 12:32

西尔维亚说：“我开始做42小时的乏食，有时每周三次，有时两次以变换一下。我没有减掉体重或尺寸。我做错了什么吗？”我喜欢这里辛西娅既检查体重又检查尺寸，因为有时候那个秤可能会欺骗人。所以这真的关乎你的衣服是否合身？那些尺寸是否在变化？如果你没有减掉尺寸，那就有点停滞不前了。

◉ 最好每周进行三次治疗性乏食，如果某周只能进行两次42小时的乏食，我仍然会至少增加一次24小时的乏食，以确保一周内有三次乏食。 12:59

现在，最好每周进行三次治疗性乏食。所以在你只能做两次42乏食那些周里，我仍然会至少加入一次24乏食，以确保一周内完成三次。在我们深入实验室检查之前，我们会快速浏览一下进食日和乏食日的情况。我们首先关注的是进食日。这通常是我们能够取得最大进步和减轻体重的时期。

◉ 首先，我们会快速查看进食日和乏食日的情况，然后再进行更深入的实验室检查。

13:26

那么在我们的进食日，我们是吃零食还是小口吃东西，还是只吃正餐？许多人会在进食日进行16或18小时的乏食，然后在6到8小时的进食窗口内频繁进食。

◉ 许多人会在进食日进行16或18小时的乏食，然后在6到8小时的进食窗口内频繁进食。

13:46

这可是坏消息。这就是小口吃东西。我们不希望这样吃。我们不想吃零食。即使是在健康、低碳水或生酮食物上，即使只是肉类，我们也不应该这样做，因为即使胰岛素水平略微升高，持续不断地刺激胰岛素也会导致胰岛素抵抗。每个人都认为他们需要吃一片面包或一碗意大利面之类的东西，这会使得他们的血糖水平飙升。

◉ 即使是健康的低碳水或生酮食物，甚至只是肉类，我们也不应该这样做，因为即使胰岛素水平稍微升高，持续不断地刺激胰岛素也会导致胰岛素抵抗。

14:14

即使在几小时内持续产生少量胰岛素也可能导致胰岛素抵抗。这并不总是关于你吃的食物量和产生的胰岛素量。这是你一天中吃饭的频率。那么在这16、18小时的乏食日里，有没有机会调整一下时间限制性的饮食呢？我们在吃午饭吗？我们在吃晚饭吗？还是中间什么都不吃？

◉ 即使是持续微量产生胰岛素也会导致胰岛素抵抗，重要的是进食的频率而不是食物的摄入量。 14:42

那么这就是第一点。第二点，我们摄入足够的蛋白质了吗？现在，蛋白质的需求量会根据个人及其活动量而有很大差异，对于女性来说，还要根据她们在激素周期中的阶段而定。但我们摄入足够的蛋白质了吗？我告诉你，当我通常要求人们记录食物日记并追踪他们的宏观营养素时，是因为我想看到这个。 

◉ 我们需要摄入足够的蛋白质，蛋白质的需求因人而异，取决于个人的活动量以及女性所处的荷尔蒙阶段。 15:07

人们在两餐之间只吃一顿饭份量的蛋白质。因此我们会调整蛋白质摄入量。大多数人在想要减肥时，每天两餐的目标是摄入约80克蛋白质。

◉ 大多数人在想要减肥时，每天两餐的目标是摄入约80克蛋白质。 15:23

当然，随着我们接近维持体重阶段，这个需求会变化。我们可能需要高达100甚至120克的蛋白质，但通常是两餐日约80克，即每餐40克。所以我们不想每餐吃超过40、50克，因为多余的部分会在那个特定时间转化为葡萄糖，导致糖异生作用。但我们确实要确保在进食日摄入充足的蛋白质。

◉ 随着我们接近维持阶段，可能需要高达100甚至120克的蛋白质，但通常是两餐日约80克，即每餐40克。 15:49

所以，确保我们不是在吃零食或者随便吃点什么，确保我们摄入了足够的蛋白质。许多人在转向低碳水饮食或生酮饮食时，他们会去掉淀粉和谷物，但不确定应该吃什么来填饱肚子，所以他们最终会选择吃奶酪、坚果和种子。

奶酪、坚果和种子如果适合你的体质，吃一些也无妨，但你需要考虑以配菜的分量食用。

◉ 许多人在转向低碳或生酮饮食时，会移除淀粉和谷物，但不确定应该吃什么来填饱肚子，所以最终会吃奶酪、坚果和种子。 16:14

你要考虑，如果你是杂食者（大多数人是），那么盘子里三分之一应该是动物性蛋白质。三分之二应该是富含纤维的蔬菜。然后你可以加一些奶酪。你可以用一些坚果和种子作为盘子上那些食物的配菜。

◉ 奶酪、坚果和种子可以作为配菜，而不是作为主菜。 16:34

所以你可以把它们当作调味品。它们本身并不是一道配菜。有时候人们确实会控制奶酪和坚果的分量，但不会吃其他东西来填饱肚子。然后他们就会不断地想找东西吃，永远不会感到真正满足。

◉ 有些人没有控制奶酪和坚果的量，也没有吃其他食物来填饱肚子，所以总是想吃东西，永远不会感到饱腹。 16:50

这最终会影响他们的饮食。那么在可食用的日子里，有没有什么办法可以调整呢？对于肉食者，我们通常希望他们在一餐中有几种不同的脂肪来源和蛋白质来源，以确保获得足够的食物。

◉ 肉食者通常在一餐中摄入多种脂肪和蛋白质来源，以确保获得足够的食物。

17:04 对于素食者，我们确实会更加精心地安排饮食，确保每餐都含有充足的蛋白质和脂肪，并通过植物性食物来涵盖所有必需氨基酸。这些是我们经常处理的替代饮食方式，以及解决其中一些问题的方法。

17:23 现在在你乏食的日子里，你喝了多少浓奶油？如果你还在喝的话，你有测量吗？很多人认为他们可以大概估计一下，但这样做通常不太理想。最近我们有一个分享社区，当他们测量后发现，他们整天在茶里喝的浓奶油几乎有一杯那么多。所以，我们想要减少这个量。我知道我和杰森多年来一直说三汤匙，三汤匙。

17:52 说实话，应该是三茶匙。所以我们真的想减少全天摄入的脂肪量。我们需要审视一下使用乏食训练的情况。你使用它们是因为你无法摄入它们，但又想在乏食日享用吗？还是因为你确实需要它们？

18:11 我们会看看我们能做出哪些改进，是否可以调整、减少摄入量，或者根据我们的需求而非仅仅想要来调整我们的乏食日。

18:26

如果那些方法不起作用，我们会开始进行实验室检查，以查看是否存在需要解决的营养不足或需要解决的额外激素失衡。

◉ 如果这些方法不起作用，我们会开始进行实验室检查，以查看是否存在需要解决的营养不足或需要解决的额外激素失衡。 18:42

有时我们需要非常注意营养储备，特别是铁储备，并确保它们达到标准水平。对于正在经历围绝经期的女性，我们通常将乏食限制在36小时以内，以确保她们能够摄取足够的蛋白质。

◉ 在围绝经期，我们需要特别注意营养储备，尤其是铁储备，并确保它们达到标准水平。 19:00

因为这一特定人群通常意味着即使她们减去了相当多的体重，也需要大约100克的蛋白质。我们尝试每餐摄入约35克蛋白质，或者在三顿饭的间隔时间内摄入，以帮助平衡激素。在围绝经期，我们经常早上吃早餐，以帮助支持甲状腺功能、支持肾上腺功能，使一些激素达到平衡状态。

◉ 在围绝经期，我们尝试每天三餐摄入约35克蛋白质，以帮助平衡激素。 19:25

围绝经期是女性一生中最具有破坏性的时期之一。因此，我们非常注重每周三次的36小时乏食。这样我们就可以在一天之内分散摄入那三顿饭所提供的蛋白质。我们会采取这些策略，查看实验室检查结果，并从实验室检查结果中为你提供指导，告诉你应该怎么做。您可能需要查看，如果有的话，或者是否有任何营养方面特别引人注目的地方，我们可以帮助您进行调整。

◉ 更年期是女性一生中最具破坏性的时期之一，因此我们非常重视每周三次的36小时乏食，这样我们可以通过三餐分配蛋白质。

19:53

但是，查看这些特定的事情通常真的有助于促进脂肪减少。好了， 非常感谢大家收听 ，下周我们还会再回来。现在先告别，祝你们乏食愉快。

</markdown>

Edit:2025.05.16

<markdown> </markdown>

讨论列表 AKP讨论 查看原帖及回帖