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Dr Doug: Brett. What are we going to chat about today?

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Breta Alstrom: Today we're talking about intermittent fasting and bone. But we're gonna deep dive on intermittent fasting. And then, if you guys have questions as always drop them in the chat, and then we'll leave some time at the end. For you guys to ask any live questions about Internet and fasting and a few bonus questions. If we have time, so feel free, if you do have questions right now, I know there were some in slack. But we're just gonna start out with like some basics on

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Breta Alstrom: intermittent fasting that way. If you're unfamiliar that you kind of get the gist of what we're talking about. So are you ready to go? You wanna get started.

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Dr Doug: I'm ready. I'm just pulling up. So I recorded a recorded on this recently, I'm just gonna pull up the actual numbers because I think some of these numbers are really interesting, so I'm ready, though. Go ahead.

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Breta Alstrom: Okay? Awesome. Well, we are generally gonna call what we're talking about today. Intermittent fasting. But it does have other names like time, restricted feeding or time restricted eating? But, Dr. Doug, can you just give us a good overview of like if we're talking about? What does that mean?

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Dr Doug: Yeah.

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Dr Doug: yeah, so there's a lot of confusion around this, too. And I think people like to use different terms just to sound different and cool, but the the whole idea of essentially when you are eating during the day this is considered your feeding window. So if you eat breakfast, then, if you eat breakfast at 8 Am. And you eat your last meal at 8 Pm. Then you are eating for 12 h. Right?

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Dr Doug: So this is a 12 h feeding window, and then, if you don't eat from, say, 8 pm. Until 8 Am. That's a 12 h. Quote unquote fasting window, so you could say, then you are doing a time restrictive eating pattern of 1212.

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Dr Doug: And what's funny is, you'll actually see studies talk about, you know, time, restrictive eating of 1212, which for me, this is not time restrictive eating. That's just eating. You know. Intermittent fasting. A 1212 intermittent fast is is eating as we would normally do. But then you start getting into the variations of that. So then, if you have, let's say a 8 h eating window going from, you know. Call it noon to 8 pm, so basically, you're skipping breakfast right? So

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Dr Doug: feeding window from noon to 8 pm. And then you're fasting from 8 pm. All the way back until noon. So now that's a 16 8. So 16 h of fasting and then 8 h of feeding, and in an feeding window of 8 h, you can likely still get, you know, 3 meals and potentially a snack in right? So it's not particularly restrictive.

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Dr Doug: There's a lot of studies on 16 8, and it's a pretty common way to do it. And again, it's essentially just skipping. Breakfast just goes against the Kellogg idea that breakfast is the most important meal of the day, but then you start getting more restrictive. So then you start seeing people doing like one meal a day, or like 20 h, fast or 24 h fast. So then you start getting pretty restrictive, and the issue here and we'll talk about this in the studies is that when you start going one meal a day, even if you could consume.

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Dr Doug: you know, whatever feeding a 2,000 calorie diet, even if you could consume 2,000 calories in one sitting and a hundred grams of protein in one sitting. You're not gonna be able to likely utilize that as well as if you were to split that up over multiple meals. So then we start running into questions of man, are you actually getting in all of your nutrients in a very, very short feeding window of whatever an hour or 2 h.

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Dr Doug: So that's definitely something that I wanted to look at. And then you can get more extensive and do multiple day fast, right? So you can do a 48, 72 h fast, which is not what we're gonna talk about today. But there is a surprising amount of literature on muscle mass and on bone health and fasting, and and show you the the research that I did for the upcoming video totally changed the way that I look at fasting and bone health.

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Breta Alstrom: Yeah, okay, here's a great question from Cheryl. Does it matter if you fast in the Am. Rather than at night, or like not eating. After 4 Pm.

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Dr Doug: Yeah, the studies that I looked at specifically on muscle mass and bone health did not make that differentiation. So generally, just because of our cultural norms. People are gonna do the fasting window in the morning because dinner, the evening meal is generally gonna be the more socially accepted meal to eat together. So it's hard to fast through dinner. And I've done this and multiple day fast, too, and it's just awkward, just like, sit down with the family and be like.

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Dr Doug: Okay, you guys eat. I'll be right here. So generally it's gonna be biased. Towards the morning when it comes to the fasting time. However, studies that do look at the differences. There is actually probably more benefit in eating earlier in the day and then skipping that evening meal. And then you just have to deal with the social implications.

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Breta Alstrom: Yeah, there's definitely a lot of positives, I think, too, with like starting like breaking that fast early in the morning, just like promotally. But when it comes to, I guess the intermittent fasting.

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Breta Alstrom: do you, I? And then we have our repeating window. But say, like, you're just eating breakfast, lunch and dinner on like throughout an 8 h fast. Would that make a difference if you did spread that over 12 h? But you were still just doing breakfast, lunch and dinner, with no grazing in between.

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Dr Doug: Yeah, not as well study. But as you start getting, it's really, really hard to study.

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Dr Doug: So you start getting into these really small variations. I think so. I like the idea of having discrete feeding periods and not just having food around and just snacking throughout the day.

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Dr Doug: so giving your your gut a clear time to digest, and then a clear time to then switch out of that mode. So you're really going back and forth. If you're constantly eating your guts, always trying to digest. But then, if you're also like working out or walking, or in a stressful environment, then it's it's a that's a tough mix, so not as well studied from what I've seen, but I do like the idea of discrete meals when possible.

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Breta Alstrom: Yeah. So just to flow into that? Alan asked, what is the minimum time to wait between meals when you're cramming them into a short period of time.

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Dr Doug: It's a good question. It's again. I don't think there's any like magic rule here. I think it's, you know. Let's say you're doing 16 8, cause again. That's where probably most of the evidence is on 16 8. So if you had 8 h, you know, trying to don't rush through your meal, but you know, eat during a discrete 30 min window, and then just do the math and and divide it out. So you have as much time in between as possible.

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Dr Doug: It's gonna give your body the best capacity to absorb, to utilize and then get out of that digest mode and then into you know whatever mode you needed to be in, so just trying to to divide it up as best possible in the feeding time that you have. If you're if you're doing that.

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Breta Alstrom: Yeah, awesome. Okay? So I feel like we've touched on pretty much all the different kinds of fasting outside of, like some of those longer, you know. Whole day 72 h fast. But why do most people start intermittent fasting.

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Dr Doug: Wayloss, I think, is the primary one, right? It just got really popular. There were certain influencers like Peter Otia.

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Dr Doug: Oh, gosh! Who's the guy from Canada, the enterologist.

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Dr Doug: Oh, he was super funny! He's still out there. I'll think of it in a minute. But a couple of very popular authors. Dave Asbury is another guy. So they made fasting really popular, and it became a way to lose weight

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Dr Doug: when you look at the studies around weight loss, though it's not particularly effective for weight loss, and that just shows up over and over again. You have to be. You have to get pretty restrictive in order for it to actually be beneficial in the long term for weight loss. I know that even if I'm doing one meal a day and not a little special case.

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Dr Doug: but even in one meal a day I can overeat my caloric allotment. I have that special capacity definitely in 8 h. If I'm eating at Lebanon is what they say in the studies. I could easily eat 5,000 calories, so it's not a weight loss tool for me. It is effective for some people, but that's the primary reason. The secondary reason would be

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Dr Doug: longevity for people looking for the like. The concept of atophagy cells in essence trying to help help cells that are aging to die. Well, basically turn on that like, let's get rid of the cells and clean the waste. There's this idea that atophy occurs with fasting. And that's true. But you can measure that in mice harder to measure in humans, though.

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Dr Doug: and so

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Dr Doug: the follow up question to that is, what's the magic window of when you're going to see the benefit and not the downsides.

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Dr Doug: And I can tell you that we don't really know. A topogy is hard to measure in humans. So we don't really know like, what what's the magic dose of fasting? Some people say it's 16. Other people say, no, it's gotta be 24, or 48, or a week, or whatever. So I think there's other ways to pull those levers on a toffogy through like Peptides and other tools, so I don't really recommend it from a longevity perspective.

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Breta Alstrom: Yeah. And so, what are some of the other benefits associated with fasting?

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Dr Doug: Yeah, number one, metabolic health.

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Dr Doug: It is an amazing tool for metabolic health. So if you're pre-diabetic, diabetic, you have elevated insulin insulin resistance. It will bottom out your insulin, not in a bad way, but just like more than carbohydrate restriction. More than anything else. The hormonal impact of fasting

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Dr Doug: will have a big impact on insulin. So for our patients that are insulin resistant have elevated insulin and metabolic dysfunction. This is a tool we leverage, and then we just encourage them to make sure that they're getting adequate nutrients. So they're not doing it in a way that's potentially harming their muscle and bone, but is a great tool for for people with insulin resistance and diabetes.

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Breta Alstrom: Awesome. And

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Breta Alstrom: I,

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Breta Alstrom: I think we could maybe break that down a little bit because we do have some questions about like insulin and how fasting impacts glucose levels. And I think that this is gonna be a little bit person dependent. But I mean at baseline, we are looking at having those insulin breaks when we're fasting. So maybe if you wanna dive into that a little bit.

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Dr Doug: Yeah. So 2 different things there, so insulin for those that aren't insulin, savvy? So insulin being the hormone that is secreted in response to the consumption of carbohydrates or excess levels of protein.

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Dr Doug: and it helps you to take the glucose that's in your bloodstream being put there by the gi system and put it into cells

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Dr Doug: very powerful hormone, very important hormone. It gets kind of a bad rap because of the obesity, epidemic and diabetes. But it's a really really important hormone.

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Dr Doug: The challenge with insulin is when we have too much of it, when it's around chronically, because it should be pulsed right? You eat a discrete meal, your insulin level goes up, and then it comes back down.

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Dr Doug: When you eat. All the time. When you eat a high carbohydrate, highly processed food.

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Dr Doug: standard American diet.

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Dr Doug: When you eat that type of diet insulin has to go up, and then it kind of has to stay up because it's trying to put away all of these calories, nutrient, deficient, but calories. So it's trying to put away all this glucose.

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Dr Doug: What happens when you get too much insulin over time is that the cells just like any signal, the cell gets basically resistant to the signal right? So this is why all hormones fluctuate. We never see constant hormones.

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Dr Doug: and so, when insulin is present for a chronic experience, long period of time, the cells become resistant, and then the pancreas which makes the insulin has to start making more insulin. And that's when you start seeing elevations of fasting insulin. That's when you start seeing insulin levels that rise really high, we measure fasting insulin in our practice. And so we do see this in people with metabolic dysfunction. So fasting, then, has a profound impact on insulin because it just like breaks the cycle of consumption.

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Dr Doug: Insulin is essentially a fed state hormone.

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Dr Doug: If you stop eating. And I hate saying this like it's so simple. Just stop eating

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Dr Doug: and then your insulin levels will fall because your bot, your glucose will fall, your insulin levels will fall in response to that. So you can see people that are diabetic. They start doing, you know, every other day fasting or omad one meal a day, fasting their insulin levels will fall from, you know, like upper double digits to triple digits down to single digits in the course of weeks.

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Dr Doug: You know these like long term diabetics that literally reverse diabetes like that. Now the secret is, then they have to keep keep doing that but it has a profound impact on insulin as well as other hormones, but massive impact on insulin from a glucose perspective. It's a little bit different. So the body has the capacity to make glucose. That's why, we can consume a 0 carbohydrate diet and not have any at least immediate ill effect.

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Dr Doug: Right? So people that are on a Ketogenic diet, carnivore diet. They're consuming essentially no carbohydrates or less than 50 grams of carbohydrates. Our liver has the capacity to break down different substrates and make glucose. So somebody who is on a Ketogenic diet who's fasting their their morning fasting. Glucose is probably not gonna be any different.

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Dr Doug: And that's why I would look at morning fasting glucose, not as the most important in my practice predictor of metabolic health, because I know I can do 72 h fasts, and my fasting glucose in the morning is the same.

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Dr Doug: because it's all coming from my liver. So glucose is a little bit different, still has an impact. It will lower it over time, but not as quickly as it'll lower. Insulin.

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Breta Alstrom: And that, I think, breaks brings us over to

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Breta Alstrom: when we're fasting. And I kinda touched on this already. What's the difference between calorie restriction versus keeping calories the same versus over consumption. And you know, how does that impact the results that we're gonna get? And what would probably be ideal. And again, it's gonna depend on what you're aiming to do with your fast. But yeah.

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Dr Doug: Totally well, yeah. So I saw some questions about this like, Can you do it? If you're underweight, it really comes down to. What are you trying to achieve? So if you're doing it for? Let's call it metabolic health.

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Dr Doug: and you're trying to maintain your muscle mass. You're trying not to lose weight, then you want to be as isooric as possible, which means you want to maintain whatever you know, the number of.

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Dr Doug: Excuse me, calories or the amount of energy that you need to maintain your weight.

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Dr Doug: So it doesn't really matter, according to the research.

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Dr Doug: If you consume that again in one meal, maybe not, but in a relatively short feeding window versus consuming those throughout the day, you're able to maintain muscle mass. In fact, in some of these studies, where they added resistance training. You're able to actually gain muscle mass as long as you stayed isochoric.

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Dr Doug: If you want to lose weight, then you have to get catabolic, and then you just simply drop your calories.

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Dr Doug: And there are plenty of people out there. There's sort of this big movement, because I spend some time in the weight loss space, and it's really fun. But there's a big movement of people that just continue to say, like, it's all about the calories. It's all about the calories calories in calories out there's some very strong voices out there, but they'll point out with fasting, and they'll say, Look, if you look at the studies on fasting. The only people that lose weight are the people that cut calories.

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Dr Doug: And it's kinda true. Now, there are some hormonal changes that go along with that. But if you cut calories you are likely to see some weight loss. And then the question is, well, why not just cut the calories. Would you see the same weight loss? And the answer is not really so. Caloric restriction

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Dr Doug: isn't as clear in the literature from my understanding. If you just reduce calories. You oftentimes don't see the weight loss that you would expect. It seems to be more clear cut in the fasting studies, but the fasting studies are also generally shorter. So you have less time to compensate. But it's a remarkable when you look at like the true weight loss studies where they cut 10% of calories you would expect to see X number of pounds lost over the course of whatever 2 years. A lot of times in those studies, they don't lose any weight at all.

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Dr Doug: And so I don't think that caloric restriction by itself is going to be as impactful as something like fasting where you're doing it very intentionally, but you're also getting other hormonal benefits that go along with it.

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Breta Alstrom: Yeah. So along with those hormonal benefits. The relationship between fasting and cortisol, do you wanna dive into that real quick.

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Dr Doug: This is where I started to pull back a little bit on fasting, so I was kind of a big advocate for it up front. I thought it was cool, and that's when I started doing 72 h fast.

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Dr Doug: You do see again. There's this hormonal shift that occurs. So you do see rises in growth hormone, which is cool. Maybe one of the reasons why we can preserve muscle mass.

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Dr Doug: Hey, Diane, I know this is awkward, but I don't know if you know that your toddler just opened that baby gate behind you, Diane Miller.

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Dr Doug: just making sure. That's okay.

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Diane K Miller: Yeah, that's okay.

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Dr Doug: Got it freaked me out. Okay, anyway. So

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Dr Doug: where is it going with that?

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Dr Doug: I'm fat, Daddy Brain.

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Dr Doug: Where was I? Head?

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Breta Alstrom: Of all, you stop the recommendation.

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Dr Doug: Oh, thank you. Okay, got it. So yeah, so you do see these hormonal changes that occur. One of the potential negatives is that your cortisol will rise.

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Dr Doug: and also epinephrine or epinephrine rise. So for people that are dealing with a lot of stress for people that are, you know, chronic cortisol elevated adrenal dysfunction. Anyway, there's some concern that this is gonna actually make this worse. So we see this more in women than we do in men. And there's it's a whole long discussion behind that. But there are studies that will demonstrate that women don't tolerate fasting as well. I think this likely has to do with when for premenopausal women, when they're fasting throughout their cycle.

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Dr Doug: men seem to be more consistent with it, but any stressed out person has the potential to be more stressed out fasting. So when I look at our patient population in general, we have an anxious, stressed out population for lots of different reasons. So fasting's not really a tool that I want to implement and add more stress to their life if that makes sense. So this is the the one area where I think fasting falls short for a lot of people.

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Breta Alstrom: Yeah. And this is actually something really interesting. If you were, gonna get a Cdm that you can kind of experiment with on yourself, and, you know, check your baseline 1st and see where where you're at and how much you're eating. So I would say, a majority of our patient population really isn't meeting enough, whether you're eating regularly or not. Probably not eating enough. And so you can take a look at that Cgm data and see like where you're at, and then experiment by eating more and

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Breta Alstrom: say, like, your glucose levels were normal at that lower level. And then you start eating more, and they might still be normal. But you can also check in on how you feel. If you have better brain fog, if you're feeling less anxious and less stressed out about things. And that can be really, really interesting to see those correlations. So along the lines of with, well, do you wanna say anything about that.

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Dr Doug: I do so. I've worn a Cgm. During an extended fast. It's fascinating the fluctuations you still get in glucose.

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Dr Doug: You would think it would just be flat line, but I had, you know, elevated morning cortisol. My cortisol was still 116. I'm sorry my cortisol, my glucose was still 116 because of cortisol. Even when I'm you know, 72 h fasted. I still have emotional responses to stress, and my glucose will rise, work out, you get a dip and a rise. These natural fluctuations and glucose you can really see when you're fasting.

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Breta Alstrom: Yeah.

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Breta Alstrom: I would say, for me, mine was mine. Mine's perpetually, low, if i'm, I like run at like 68 to 70. If I'm eating one meal a day. But yeah, so definitely, experiment and see where you're at and along the lines to like W around women. And potentially, you know, fasting and hormone levels being a little bit different. Audrey asked. If

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Breta Alstrom: I don't. Just in the context of like Stacy Sims looking at. You know the research on fasting and women. And then also, you know, is 12 h. Okay, versus less. I mean in general for women. What are your thoughts around fasting and I know we're gonna dive into bone health a little closer to the end. But just on polls that.

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Dr Doug: Yeah. So I've read her books. Listen to Stacy Simpson. Podcast. There are some other authors that have similar perspectives. And really their perspective is what's the point.

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Dr Doug: you know, fasting isn't going to provide, especially a female, and she's into the athletic space. So especially a female athlete. There's not going to be a performance benefit to fasting. So why put yourself through that?

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Dr Doug: I think, for the majority of our female patients, unless they're obviously diabetic, or they have elevated insulin. I'm not even talking about it as a tool. I really don't talk about it as a tool very often because of our patient population, anyway. But I really think that for the women that I know that have tried it, none of them are still doing it.

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Dr Doug: and I think you see that pretty consistently, and the influencers that were pushing it. They're not really pushing it anymore. And they just it sounds cool. It's fun to do. It's fun to think, man, I can go 3 days without eating, and actually feel really good.

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Dr Doug: But then, on the long term, what's the real benefit.

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Breta Alstrom: Yeah.

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Breta Alstrom: And I would say 2, when we just going back to the calier restriction versus being isochoric or over consuming when it comes to. I know a lot of people are looking at ways that they can take fewer supplements, and in general

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Breta Alstrom: to get in all of the vitamins and minerals you need on a daily basis, without, you know, factoring in digestion, absorption, and all of those things. You pretty much need to be eating around 3,000 calories. And I know most of our patients and a lot of people here aren't gonna get anywhere near that. Or you're feeling really far away from that right now, and so finding ways to eat less might not actually be the solution that you're looking for.

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Dr Doug: Right.

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Breta Alstrom: So.

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Dr Doug: Yeah, and we'll we'll talk about the research. I mean, there.

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Dr Doug: there is this idea that okay. Well, if you, if you can manipulate your body so that you're increasing growth hormone. Naturally, you know. Maybe we can actually gain some muscle in bone without pushing calories up as high, you know. Is this a hack that we can use for that? Well, I'll tell you what the studies show there. The short answer is not really.

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Breta Alstrom: Yeah. And then along the line of Stacy Sims. I ha! I haven't read her book on what's next level? But is it different for women who are postmen. Apostle versus proven apostle.

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Dr Doug: Yeah. So I've read all of her follow-up book. And then her initial book was called Roar, which I've read parts of since. That's not really my patient population.

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Dr Doug: Well, bye.

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Breta Alstrom: I've read all of, so I can fill in the gaps.

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Dr Doug: So between the 2 of us, yeah, we know all of what she's saying, and from the next level in that book she really gets into again. It's the stress side. It's the fact that being postmenopausal is a naturally, inherently stressful.

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Dr Doug: higher cortisol catabolic state.

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Dr Doug: So why would we use a tool that's going to push us further in that direction. So she's really not a fan. In fact, she's just like eat eat all the time.

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Breta Alstrom: Okay? Awesome. Next up we have. Well, I guess I just wanna touch on. Are there any other like perceived negative

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Breta Alstrom: consequences of fasting that we haven't already touched on.

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Dr Doug: Yeah. So I think as we talked about stress, I would say, probably misconceptions around how good it is for weight loss, because it's not particularly good for weight loss. Is it going to help you build muscle? We'll talk about that

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Dr Doug: other negatives, maybe. I mean, you could argue. Some people would say, like, you get into electrolyte disturbances right? Because we're not talking about water fasting. This isn't Ramadan. This isn't a religious fast. So just be clear.

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Dr Doug: Water definitely doesn't break a fast. Most non-nutrative liquids aren't going to break a fast.

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Dr Doug: But people still get electrolyte issues. I think

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Dr Doug: you start urinating more as a part of fasting. That's part of the the hormonal shift that occurs is that you start, you know, excreting more liquids. So people get dehydrated. So there's some potential negatives there. You can get light headed blood pressure. It could be different, Susan, that coffee question has been asked a couple of times. So does coffee break a fast. It depends on what you put in it. So black coffee does not break a fast. But if you go to Starbucks and get a frappuccino that'll break it fast.

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Dr Doug: I use the rule of 50 calories. And so if it's under 50 calories, you're probably not gonna have an impact on your fast, the more fat it is. So. For example, I like this number because it's a tablespoon of cream, and I'm a big fan of of heavy whipping cream, so I can put a tablespoon of heavy whipping cream and my coffee, and I'm not gonna break it fast. Not that I fast, anyway. But when I did, that was my rule. So coffee with one tablespoon of cream will not break here fast.

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Dr Doug: Does that make sense any other negatives I'm missing there, Brett.

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Breta Alstrom: I don't think so. I did want to talk a little bit more to about the considerations of like what breaks the fast. And can you? I mean you said non nutritive liquids. And I would say, probably water with a little bit of lemon juice is gonna fall under that probably not

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Breta Alstrom: drinking that much limited. And then what about supplements? And can you take your supplements.

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Dr Doug: He, yeah, it's.

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Breta Alstrom: Like, what the.

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Dr Doug: Extremely variable. So like again, I have these awesome gut things where, like, I'm blessed to be able to eat 5,000 calories in one sitting. I can also take a handful of supplements and not get nauseous.

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Dr Doug: With a few exceptions, I would say in general, though supplements are designed to be eaten with food.

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Dr Doug: Right? So we're gonna absorb almost every supplement in Peptide that you're gonna take orally is gonna be absorbed better, with a few exceptions like Bpc. Should be taken on an empty stomach, thyroid, obviously taken on an empty stomach. But for the most part supplements should be taken with food, so I would not take them while fasting, cause you're probably gonna end up with an upset stomach

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Dr Doug: and not absorb anything.

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Breta Alstrom: Yeah, and then, yeah, like a lot of their fat, soluble vitamins. Right? Like, you need to have those with a source of fat, and so that brings us to coffee with collagen peptides in it, and I don't know. I would lean maybe more towards the direction that that would be a a

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Breta Alstrom: not as

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Breta Alstrom: safe for your.

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Dr Doug: Not as not as innocent.

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Breta Alstrom: The print.

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Dr Doug: Yeah, I I agree. I've never looked at any studies on that. But you think about it. If you're getting the equivalent of, you know 10 to 20 grams of protein in a drink. That's gotta have some kind of metabolic effect, is it? I mean, is it that significant? I don't know but it it could impact your fast. Yeah.

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Breta Alstrom: Yeah.

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Breta Alstrom: I'm sorry. Just answering a message, but.

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Dr Doug: Yeah, I saw that.

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Breta Alstrom: I like, I guess, on the with the insulin, though, and the Peptides when it comes to protein, we don't often think about protein impacting insulin levels. But protein does use a small amount of insulin to be able to like, quote, unlock the muscles, utilize those components so it has a more delayed effect. So just as you're thinking about that when it comes to that insulin resistance

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Breta Alstrom: protein, we want you to have a lot of protein. It doesn't have it still has an insulin response, though. So just so, everybody.

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Dr Doug: And especially the more protein you eat. So if you're eating. So, for example, like I'm I'm pushing my protein limits, and I know that I'm seeing glucose spikes as a result of protein consumption. Because when you consume, you know, 80 grams at a time, a hundred grams at a time, you're gonna see a spike of insulin because your body has to has to use insulin to put it away. If you're getting 30 grams. Probably not gonna see much of a response. But there's there's radiations that everybody's gonna be different, too.

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Breta Alstrom: Awesome. Alright. Now, what we've all been waiting for? Let's talk about fasting and phone health, how does fasting impact phone help.

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Dr Doug: So when I so I had this hypothesis that I didn't really test because it didn't really matter early on. And I'm pulling up the actual study. I've got it here somewhere.

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Dr Doug: So this has been studied. So let me just talk about the bone health thing. So basically, what they showed in these studies. So I'm gonna look at this one right here. So there's a study, this study, the effect of time, restrictive eating and weight loss on bone, metabolism and health. 6 month. Rct. So all these studies are gonna be small. None of them are perfect. But this is a 2023 Rct. With 42 individuals. And they basically looked at my, you're in my document. Brada's.

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Breta Alstrom: Sorry.

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Dr Doug: It's okay.

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Breta Alstrom: Pink.

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Dr Doug: Paint, highlighting.

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Breta Alstrom: Article in the chat, though, for anybody who wanted to pull it up.

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Dr Doug: Yeah, so basically, time restrictive eating versus the standard American diet. And they were using a I think it was like a 1212. So again, like, is this really time restrictive eating?

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Dr Doug: Ok? But what they saw is that the Bmd didn't change, and after 6 months I wouldn't expect it to.

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Dr Doug: and that was in the not the weight loss. Let me make sure I'm saying this right

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Dr Doug: and weight loss responders. They're looking at people that lost weight and didn't lose weight. And then

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Dr Doug: so let me say that again. So for people that didn't lose weight, there was no difference between the groups for people that did lose weight. There was a loss in bone marrow density. So this goes to show. And, Lorna, that question that you asked earlier.

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Dr Doug: which is, can you lose weight and gain bone at the same time? I think the answer is probably not, usually, because if you're in a catabolic state, if you're breaking down fat. You're also gonna be breaking down muscle and bone. It's really hard to build

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Dr Doug: one tissue and break down another. And this is a great study. That shows that. So let me just review that because I sort of did that in a bad way

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Dr Doug: in this study, where they were using time, restrictive eating. If people lost weight, they lost bone marrow density. If they didn't lose weight, they didn't lose bone marrow density. But again, 1212 is really not much fasting, that's normal eating.

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Dr Doug: Then there was this study. Did you give them study? 5

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Dr Doug: in here, Brett.

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Breta Alstrom: I will!

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Dr Doug: This. Rc. This is this is a Meta analysis.

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Dr Doug: Meta-analysis of 7 Rct. Is a total of 313 patients, and there was no difference in Bmd at all, including those that lost weight. So there's some hope for those of you that want to lose weight.

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Dr Doug: did you? Did you, did you?

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Dr Doug: No detrimental effects on bone health compared to those in the control group? So these are, you know, 5 studies anywhere from 16 8 to 1212 fasting so probably included that other Rct. Actually

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Dr Doug: another one

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Dr Doug: 2017 RCT.

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Dr Doug: no differences in bone metabolism, markers in premenopausal or postmenopausal women with fasting.

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Dr Doug: So then they were measuring Ctx.

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Dr Doug: So that's kind of interesting

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Dr Doug: that one's fat Mastlin, Mass.

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Dr Doug: So I think those are all of the studies on bone health.

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Dr Doug: And so my conclusion is that it's not as bad as I thought. My hypothesis was that we should really not fast if we want to maintain bone health.

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Dr Doug: but it looks like as long as you're not losing weight, then you're probably okay and you can use it if you want to. I would argue, why but if you feel like there's a benefit from an autopsy perspective longevity, perspective, you simply feel better fasting, which is totally a thing, then you could certainly consider it. Just make sure that you're getting adequate calories, adequate protein.

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Dr Doug: so big big thing.

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Breta Alstrom: So I think that ties into a few questions that we have here. Carrie said. She did intermittent fasting with an 8 h eating window. She could never get down to a 6 h window to improve mitochondrial function, and got health after, and health after covid. But could this have caused accelerated bone loss. During this time.

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Dr Doug: Sure, if you were calorie restricted, which a lot of people at 16 8 would be.

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Breta Alstrom: Yeah. And then you did mention Ctx. But is there? Have you like from the research, been able to see if there was like a correlation to changes in Ctx and p. One np. Based on fasting.

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Dr Doug: I didn't see anybody that measured P. One and PA lot of people will measure bone elk, foss as a measure of bone building bone specific alkfoss rather than p. One. And P. It's not as good of a marker, but some of them did measure ctx, and it didn't really seem to change. So it doesn't look like it's having a dramatic impact on bone metabolism. Again. As long as you're isooric you're getting adequate calories.

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Breta Alstrom: So then the biggest question can you lose weight and hold on at the same time.

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Dr Doug: It's probably possible. It's just like the people like back when we used to work with more men. Men like they always have the same goals they're like, I want to lose fat and build muscle. I'm like cool dude.

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Dr Doug: It doesn't work like that. And so you you can. But you almost have to like. It's like 2 steps back, one step forward like, which one are you focusing on? And so I just had a patient yesterday as a great example where she came in, and her

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Dr Doug: primary goal was bone health. But her secondary goal was weight loss, and she went and talked with her primary care, Doc, and put her on a glp one. So she's on semig. And she's like, Yeah, I stopped tracking my food because I just wasn't eating anything I'm like, oh, cool. So I'm excited to see your Dexa.

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Dr Doug: because she's choosing weight loss over bone elf, which is fine like she was nearly diabetic. She had hypertension. She's dealing with the consequences of metabolic dysfunction. So that's fine. So we talked about it. And I was like, okay.

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Dr Doug: stay on your go. P. One.

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Dr Doug: but start tracking again, at least. Track protein. At least show me that you're getting adequate protein so that you can. She's still doing resistance training.

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Dr Doug: You still stimulate the muscle. Let's use all the tools. Let's use the Ea's. Let's, you know. Let's start using collagen. Let's give your bodies what it needs to maintain some muscle mass while you lose weight. Then let's get rid of all your metabolic's function, and then let's focus on bone health.

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Dr Doug: It's good to pick one.

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Dr Doug: so I would not encourage people to do both, because you're probably just going to be frustrated and not do either particularly well.

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Dr Doug: If you want to lose weight. Let's lose weight. If you want to build bone, let's build bone. I would not try to do both.

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Dr Doug: I know there's a few people here.

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Breta Alstrom: In general, too.

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Dr Doug: Right now.

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Dr Doug: just seeing I'm seeing some faces of people I know.

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Breta Alstrom: Starting to just like improve your nutrition overall. That's gonna have several metabolic benefits, even if weight loss isn't 1 of them. So you know also, sometimes separating the 2 can be really helpful and prioritizing your goals like, if your goal is bone health, then maybe we need to just focus on the metabolic benefits that you can get from having a healthy diet and being well nourished and put weight loss on hold for a sec.

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Dr Doug: Yeah, or I mean focusing on body. Comp, too. Right? So like depending on how much weight you have to let go of improving your body composition, increasing muscle mass, and maintaining your weight.

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Dr Doug: you're gonna look different. You're gonna feel different. Your clothes are gonna fit differently. So there's something to be said, too, especially for women who have not focused on muscle mass ever in their life. They're gonna feel and look very differently when they focus on muscle mass.

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Breta Alstrom: Yeah, I think the theme of the week has kind of been throughout all our provider meetings have been people, and and especially after Nick Trivia's session, just people a little scared of doing resistance training and doing activities that maybe they didn't think we're for them before. But it can make a huge difference, and it can help you reach a lot of your goals, or just maybe reframing some of your goals. And so you're gonna look better. You're gonna feel better even if the number on the scale didn't change. And you're still gonna.

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Dr Doug: Totally

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Dr Doug: totally, and and Sean.

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Breta Alstrom: So that's not hard.

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Dr Doug: Shout out to shout out to Becky, right now, who's doing resistance training just like sitting here listening. What what a culture we have of somebody who's resistance training while doing a while doing a a zoom. I love it.

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Breta Alstrom: Awesome. And then another question here, if I stay in a 5 pound weight range that fluctuates is that gonna impact the loss at all?

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Dr Doug: Again, I think if if we're focusing on Bodycom, not worried about weight gain or loss.

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Dr Doug: if we're

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Dr Doug: if our weight isn't changing, that's probably. Okay.

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Dr Doug: There are not enough studies looking at improving bone health to know? Like, do you? Do you really have to gain weight to gain bone? I think you would likely gain more bone if you gained weight. But then eventually, you're gonna have to lose the weight. So you know, let's not. Let's not create a problem. But probably I think that sort of maintaining a 5 pound fluctuation is probably fine. Losing 2 pounds is not gonna result in the loss of a lot of bone. Right? It's it's the like for this patient I was chatting with yesterday. She's lost 40 pounds in a really short period of time.

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Dr Doug: I'm really not excited to see her, repeat Dexa, because I'm sure it's not better so. She's losing weight very rapidly. Most of that's probably coming from muscle.

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Breta Alstrom: Yeah, and also to like in reframing that, like, you know, weight doesn't always fat. So if you are losing weight, you might not always be losing fat, and if you are gaining weight you might not always be gaining fat either, so it can. You know you're gaining weight. Fingers crossed for helping you gain muscle. But a little bit of that can be protected in our patient population. So another question, do you Count protein from Peptides is the same as eating meat.

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Breta Alstrom: Like collagen peptides, hydrolyze protein. All those things.

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Dr Doug: That so?

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Dr Doug: collagen? I?

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Dr Doug: The answer is, yeah, kind of so I do count it. I would not get all of your protein from collagen cause. It's not a complete protein, but it's only missing one amino acid, and as long as you're not globally tryptophan deficient, you're probably fine. The protein powder sources. So when you're talking about like whey versus beef, isolate versus even some of the the veggie proteins like P. Those are technically complete proteins. So yes, I would count those 2.

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Dr Doug: I do think there's a difference in the function, though, of a protein powder versus getting it from whole food. So I understand, and I have to as well in order to hit my protein goals. Use some kind of a powdered supplement, because what I'm what I'm doing is super physiologic, but it's hard for people who haven't eaten that much protein to get to their protein goals. So then I would rather you get there and use a powder than not. Get there if you could get there through whole foods. That's probably better.

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Breta Alstrom: Yeah.

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Breta Alstrom: awesome. Well, I do have a couple of more questions for the chat, but I do. Wanna I think we're gonna stray away from intermittent fasting a little bit. So I wanna wrap this up real quick. But at the end of the day, who is fasting for, and who would you recommend it for versus.

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Dr Doug: We didn't really talk about the the muscle mass side. So, but the conclusion from the literature was, you can fast and lose weight, and it looks like maintain muscle mass. So there is like a muscle sparing effect of losing weight through fasting. But keep in mind that when they show statistically significant weight loss. It's like

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Dr Doug: 4 pounds over, you know, whatever a year, you know. So it's it's really minimal weight loss in maintaining muscle mass. So it's a tool. I think it's like a dialing in tool, right? It's a fine tune tool. It is not a I wanna lose 50 pounds kind of tool. You're not gonna maintain muscle mass, if you're doing that

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Dr Doug: from this concept of who is it best for? Again, for me, it's metabolic health. It is a powerful tool for metabolic dysfunction. And I think for people that struggle with cravings, that struggle with. I can't stop.

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Dr Doug: I can't stop eating. Once I start, I can't control my my portion sizes. There might be a role for people that are overeaters sort of craving eaters if they can stick to fasting like if they do fine with an all or nothing phenomenon. And they just have. They struggle to eat, you know a portion, or, you know, to stop eating at a certain time.

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Dr Doug: If fasting helps them do that, that's probably Ok. Just watch that you're getting adequate. Nutrition is what I would say, especially if you have osteoporosis.

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Breta Alstrom: Yeah, definitely, cool. And then I I also think, too, as the you know, when we connect, like intermittent fasting to just being in potentially like a more Kitogenic state. There can be other, you know, benefits for your brain and things like that and other like psychological conditions. But it's almost never in a calorie restricted state that you're getting those benefits. So even if you're looking at doing that, to treat

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Breta Alstrom: or address other concerns that you might have. You still need to make sure you're getting adequate nutrition. Well, awesome. Okay. I have some questions in the chat, but actually, I'm

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Breta Alstrom: some of these I think we can answer in slack. But if anybody wants to jump on, live and ask their question, you are more than welcome to do that now.

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Diane Gould: It's Diane I I have a question that I did put in the chat there.

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Diane Gould: Hi! I'm under weight.

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Diane Gould: I

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Diane Gould: eat as much as I can. But I and I do a lot of the, you know I'm

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Diane Gould: do a lot of resistance, training, and stuff. But with regard to fasting. I unintentionally fast, I guess

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Diane Gould: 12 h.

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Diane Gould: because I do try not to eat after 8 Pm. For the rest and digest reason, and I don't eat.

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Diane Gould: I don't eat my 1st breakfast until

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Diane Gould: essentially after 8 Am.

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Diane Gould: Is this safe and healthy for me?

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Dr Doug: Yeah, I I again, I think that a 1212 time restrictive eating pattern is not. I don't think we should call that intermittent fasting. This is eating, I think an overnight fast is totally normal. It's what we've done for as long as as far as I know, as long as we've been humans. So that time for your body to rest and digest, I think, is absolutely appropriate. 12 h is plenty of time to get all of your nutrients in.

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Diane Gould: And it doesn't. Could there be an effect of what I heard you mentioned something about the electrolyte factor? That's 1 of the factors that can be.

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Diane Gould: I do seem to have problems getting keeping my

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Diane Gould: my minerals, my blood test mineral test

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Diane Gould: at a great level. And I I know, and I do take an electrolyte each day when I go to the gym and all that kind of stuff I but could that, could that could the electrolyte be a bit of a factor for me in that 12 h, and maybe do some electrolyte in my water 1st thing in the morning

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Diane Gould: rather than wait until, like.

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Dr Doug: Totally.

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Diane Gould: Block.

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Dr Doug: Yeah. And so there's component of that could be hydration. Component of that could be. You know what's happening with your adrenal glands. Do you have dysfunction? Is your Aldosterone elevated which is affecting your kidneys, and you're excreting more than you would otherwise. There's a lot of things that are a lot of things that can contribute to that, and we do find, especially in post menopausal women.

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Dr Doug: Women who are underweight have been under nourished, probably at some point in their life. They have electrolyte challenges. And so this is where, like electrolytes, probably more than once a day, like probably all the time you know, which like sounds crazy like, why would we need to do that? But you're you're just not starting at a neutral state. You're at a. You're in a deficit. So building up, building up that capacity, restoring the things that have been deficient for a long time.

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Diane Gould: And things have been deficient for a long time. That's part of the gut problems for at least a decade basically a lifetime of it, but significant for 10 years of malabsorption, which I have now gotten through. But so

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Diane Gould: will Will will eventually like, say, a year or 2 down the road by electrolyte balance like that will, you know the body is supposed to be a mir. You know. Miracle thing of of being able to heal? Or might this be something I need to be cognizant of.

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Diane Gould: you know.

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Diane Gould: 5, 10 years like for life that I'm simply going to need more of those electrolytes than the average person.

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Dr Doug: Good. I I can tell you, when I say something.

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Breta Alstrom: Yeah, so it definitely, it just depends on what what you need. If you feel like you eat actually like a really clean diet, and you're still struggling to gain weight. One of the biggest things that you can actually do is start adding in more salt, and you likely like need a lot more salt, because to utilize energy when you like, when your body digests food, you have a sodium potassium pump that like brings all the nutrients in.

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Breta Alstrom: And so if you're also not getting enough sodium, then you're gonna struggle to like optimize that absorption, anyway.

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Breta Alstrom: And then, along with I don't know what electrolysis you're taking. But we also have a question about what re electrolys we recommend. And there's like a few different things you can do based on what your needs are, and if you do or don't want any sugar or artificial sweeteners in your electrolytes. But

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Breta Alstrom: ultima is like a really great brought what I call like a broad spectrum electroly that you can use, which is like, it doesn't have very. It has a lot of different, like a lot of variety in it, but just not a lot of anything which is, can be a good starting point. And then, if you do need a lot of extra salt. There's 1 called Lmnt, but it just has the sodium potassium and magnesium in it, so it's not like as many things.

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Breta Alstrom: But then we also, if you're struggling with minerals, the beam mineral products be am. Those are actually really helpful. You won't. You can't necessarily tell all the things that are in them. But it is a really great boost to your system.

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Dr Doug: So, Diane, I'll I'll drop I'll drop those in here.

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Diane Gould: I appreciate that. No, that that this is wonderful, because it's always been. I know that.

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Diane Gould: And I

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Diane Gould: I do think I wake up dehydrated. To be honest, I drink my glass of water, but clearly there should be something in it right? So I appreciate that, because that's that fasting when you're when you're not doing it for losing weight like

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Diane Gould: that's you don't know what your body's looking for hours before you actually put anything in it.

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Breta Alstrom: Right.

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Dr Doug: Yeah. So I think so. I use beam. I use all 3 of those. So I use beam

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Dr Doug: in in the morning. So it's in my 1st water bottle.

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Dr Doug: and I like the research behind beam. I like the principle behind beam. There are a lot of different versions of it. I like that company. And there's a video I have on Youtube about it. Ultima is sort of my go-to.

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Dr Doug: for if I'm not using it for any particular reason. I like the flavor most of the ones, although the 2 that we talked about do have artificial sweeteners in them which I don't love. There's not much, but there's some for those that are sensitive to artificial sweeteners. There are some brands without, and, Brett, I can't think of any off the top my head, but none of them taste very good.

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Breta Alstrom: I'm pretty sure it's I'm pretty sure it's bio. I think they make a a sweetener free one, but if you're looking for something that's sweetener free. I would just use beam, cause beam doesn't have.

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Dr Doug: And then element with assault load. So I use that if I'm going more ketogenic, if I'm lower, Carb, if I am, you know if I am doing some time restrictive feeding or calorie restriction, then I'll go. Lmt. And I I do feel a lot better with more salt.

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Diane Gould: Wonderful. Thank you so much. This clears up a lot for me. Appreciate it.

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Dr Doug: Yeah, no. Problem.

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Breta Alstrom: Anybody else wanna jump on and ask a question.

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Dr Doug: Cheryl. Does.

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Dr Doug: Cheryl. Do you know how to.

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Cheryl Edwards: Yeah, I'm unmuted. Can I put the beam into my amino acid drink in the morning before my workout.

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Dr Doug: Yeah, you could put beam in anything.

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Breta Alstrom: I I'll do, being elementary and ultimate altogether so.

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Cheryl Edwards: Put electrolys in there, too.

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Dr Doug: Totally.

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Breta Alstrom: Yeah, yeah.

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Cheryl Edwards: Wow!

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Dr Doug: Yeah, and college and creatine, and you should see what I put in my water.

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Breta Alstrom: Yeah, yeah.

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Breta Alstrom: Alan, what's up? Go ahead and ask.

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Al Kral: We touched on it before on the fundominos. We're in this instructions, it said, not to eat with dietary, protein, or fat, or whatever.

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Al Kral: and

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Al Kral: we never went anywhere.

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Dr Doug: I need. I need to reach out to Dr. Cohen about that cause. It doesn't make sense to me. Brett. Any thoughts on on. Why, they would have that on there. I'll I'll talk to the horse's mouth about that. So.

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Al Kral: I said, it's okay to eat it with carbohydrates, but not with dietary.

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Dr Doug: Protein. Yeah, I don't know why.

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Al Kral: Bed.

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Breta Alstrom: No, my only thing would be that if you your body only has so many receptors for so many things right? So a lot of stuff that you eat is never gonna get absorbed like that's why, you know, even when you take really high doses of vitamins your body will choose how much it wants to absorb or you've just maxed it out. So if you're trying to get high doses of certain amino acids, and then you have. You know, you've filled up your receptors with

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Breta Alstrom: non of like those amino acids that aren't essential. Then they could impact the absorption of them. But I, personally don't think it'd probably be that big of a deal. I would just still use them.

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Al Kral: When I it's.

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Breta Alstrom: Doesn't.

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Al Kral: When I program when I key them in on the chronometer. Now, it's like my protein is like sky high. But you said don't count it right.

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Dr Doug: I wouldn't count that one. No.

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Al Kral: Okay.

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Dr Doug: There we go, perfect.

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Al Kral: Sometimes it puts me up to like 200 grams. I'm like, Wow, man, that's a lot.

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Dr Doug: So I just. I just asked Dr. Cohen who makes that product. So I'll drop in Hell span what they say.

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Al Kral: Okay.

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Breta Alstrom: Awesome. And then I just wanna circle back to one electrolyte. Question, can I take too many electrolytes?

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Breta Alstrom: No, it depends on what you're taking. You can take too much of the Lm, T. So just know. It does have a thousand milligrams of sodium. But also, if you're eating like a very what we call it, clean, whole foods based diet. You're probably not getting much sodium from other things. And if you're not like active and sweating out salt. Then, you know, I would limit that to one per day, probably. But as far as the ultimate goes, you're gonna be okay, you know.

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Breta Alstrom: Yeah, yeah.

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Breta Alstrom: so awesome. Alright, Lorna.

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Breta Alstrom: wait. You just muted yourself

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Breta Alstrom: alright. There you go.

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Lorna Nichols: Yeah, this has been answering a lot of my questions.

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Lorna Nichols: mixing nitric oxide powder

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Lorna Nichols: with electrolytes.

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Lorna Nichols: Any problem with that.

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Breta Alstrom: I do. I put pomegranate powder in my my water in the morning.

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Lorna Nichols: Okay? Cause, you know, i i i can tend to get sort of hooked on the taste of those

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Lorna Nichols: natural flavors that just really draw you in, and then I just want more.

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Lorna Nichols: So I'm trying to limit that a little bit. But, boy, I can get going on that and just want that taste

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Lorna Nichols: and the amino acids, you know everything dumps in some natural flavor, and if I start making into drinks and just start sipping on it.

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Lorna Nichols: I can go through quite a bit. So what I'm hearing is as far as the amino acids, the electrolytes

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Lorna Nichols: and even nitric oxide. I don't have to be worried about measuring and being careful about too much too little.

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Lorna Nichols: Is it.

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Breta Alstrom: Generally.

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Breta Alstrom: No, but like with the nitric oxide powder depending on what you're using, that will have a carbohydrate load with it. So if you are trying to like aim for a lower carb drink. Then I maybe would reassess how you're doing. You're not nitric oxide and then again, it just it depends on all the extra things that you're putting in. Like, if you're adding a creatine powder, you're definitely gonna want to measure that out for sure. Do you have any other thoughts on that.

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Dr Doug: Yeah, at at some point to, there's like, your water becomes sort of undrinkable, becomes like a gelatinous mixture. But, as far as like, you know. Are you doing something dangerous? Pro? Probably not. Your body has a really good capacity. Your gut is really good about limiting how much it's absorbing. So like, if you're getting too much, you know potassium to some extent, but certainly like magnesium, other electrolytes. You're gonna pass them before you're gonna overdose on them.

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Dr Doug: Yeah, I think Gail has her quite hand up.

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Gail Mauthe: Yes, I'm I'm taking algae, cal and strontium, and I'm taking a number of other vitamins vitamin. B.

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Gail Mauthe: see, you know those kinds of things, and I'd like to take. I listen to your video on on the algal and the strontium, and there was a 3rd one in there that could kind of wrap up that package and

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Gail Mauthe: make it into a nice little bundle. And I I think I'm interested in that. And taking that so I could eliminate some of the other things that I'm having

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Gail Mauthe: to take.

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Dr Doug: Yeah, like trying to package them together can save so many capsules. And that's 1 of the reasons why we do sort of. I guess we endorse Al Jakal. But we recommend those products because of the way that they've put them together. So the Aljakal plus and the D 3

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Dr Doug: is a lot of things in essentially what is 5 capsules a day?

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Dr Doug: And then depending on somebody's unique circumstances, we can pair other things with that. But that's a really good starting point for most people.

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Gail Mauthe: Okay? And in terms of ordering. i i i'm still working through the process of onboarding in terms of order, the ordering them right now.

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Gail Mauthe: Is there somewhere on the site and health span, or that I can go ahead and order these products? Or do I still need to go through Amazon.

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Breta Alstrom: No. So if you are in hell, span Nation, there is a link. If you go to tools and then supplements. There is a link for Al Jakal that has a discount, but it's only on your 1st order. And it should be 10% off. But if you are an ob experience like year long, full service member. Go ahead and reach out to like your onboarding team and tell them because you have an extra discount there. So if you are like a full year client, then there's extra bonus benefits.

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Gail Mauthe: Okay.

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Gail Mauthe: so that would mean my dietician.

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Breta Alstrom: Dietician or

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Breta Alstrom: Samantha Tiffany. Okay.

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Dr Doug: Samantha. Oh, there you go! I don't even know anymore. Tiffany or Samantha. There you go.

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Dr Doug: Our team has grown so fast. Hi, Gail, welcome to the patient.

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Gail Mauthe: Thank you. Happy to be here.

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Dr Doug: Yeah. Great.

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Dr Doug: Hi, Jim.

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Breta Alstrom: Oh!

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Dr Doug: Yeah. Well, I just wanted to. There's so Carrie has a great question, but we can answer Jim's first, st since he raised his hand so patiently.

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Jim: Hi, guys. I got well, you had your Youtube video about the 3 things that you most recommend algae, cal strontium.

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Jim: and the d. 3 complete. I can't find the d. 3 complete on either full script or on Algae Calzone website.

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Breta Alstrom: So d. 3. Complete is not on full script. It should be on the outl website. But let me just pull that up really quickly, and then if we wanna answer Kerry's question, Jim, I'll have an answer for you in like.

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Dr Doug: Yeah. And I can speak to that a little bit, too, before I get to Kerry's question.

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Dr Doug: the D 3 complete. The margin is so much smaller, because what they have in it. So all the proprietary trademarked products that are then put together, those are really expensive supplements to make. So their margin is much smaller. To stay competitive.

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Dr Doug: Full script would essentially take their entire margin, so they would actually be paying full script to sell their product. So they don't have it on full script that I don't know if they're ever going to. They would have to increase the price to do that. So they they do sell it through their website bread. I can work that out, and we are ordering it for people. So I know that it's available.

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Dr Doug: so I'll let Brett figure that out. And then Kerry Lofquist asked on the chat, is there any danger to drinking just plain water? And I think this is a really important point, which is that when we're drinking plain water

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Dr Doug: kinda depends on. Is it coming from a well? Is it coming from a city water supply. Is it being filtered, is it? Are you going through a like a an ro system? Reverse osmosis system? Is everything stripped out of it. So water for most people is no longer natural water, right? So it's it's some. Some process has happened to it, and it's likely adulterated with all kinds of, you know.

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Dr Doug: pharmaceuticals, and there's all kinds of hormones in there. So it's crazy. What's in our water. So I encourage people to

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Dr Doug: definitely filter their water, even if it's coming from a well, if you're getting natural water, if it's coming from a city water supply. Oh, my gosh! Please filter your water. We have some filter recommendations. I think, Brett, I don't know if they're in Hsn. We do have some for our patients, and there's some really simple, inexpensive ways to filter water doesn't have to be crazy, expensive. But you can also then over do it right? So people that are using an ro system. So if you're not familiar with that, basically

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Dr Doug: takes the water, and I don't know what the process is, but I guess it's osmosis, but it strips everything out strips everything out. So there's no minerals. There's no nothing.

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Dr Doug: Then it's truly just hydrogen and oxygen. But that's not really water, either. I mean, technically, it's water, but water should have natural minerals in it, it should have structure to it. There should be something to it. So really, Ro, water is like dead water. So then you need to remeneralize it. You probably need to add something else to it. And then there's a whole structured water topic which I don't. I can't speak intelligently on, but I would definitely add stuff to normal water.

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Dr Doug: pure water in order to give it back what it once had. So if you're getting like if you live near a spring that was clean and is bottled for, like Gerald Stein, like that's real water. But what we're getting out of our tap is not.

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Breta Alstrom: And Jim, I am going to

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Breta Alstrom: I'm gonna ask the Alja team where you can order that because I I can't find it either, so I'll just ask them and put it in the group.

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Breta Alstrom: Interesting.

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Dr Doug: We have a slack channel with Aljakal, so we'll get right back to you.

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Dr Doug: Beth. Beth. Yes, pfas! I just did a post on this. That's probably not out yet. Pfas forever. Chemicals are in our water also, endocrine disruptors and evidence that for young people expo more exposure to pfas is equal to lower bone, mineral density, strong association there.

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Dr Doug: Lauren. A last question, and then I got to go.

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Lorna Nichols: Mentioned. Gerald Steiner is the natural. Well, I'm not sure if it's natural. If they add, it is the calcium. And Gerald Steiner say.

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Dr Doug: It's real. I mean, there's a lot of calcium, and Gerald Steiner. They don't add it, or they say they don't add it.

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Dr Doug: Is it safe.

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Dr Doug: I would just consider it part of your natural calcium absorption, and from diet it is more than you would expect to see from other water, though, for sure

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Dr Doug: I don't know why it's so high, but also I can't imagine that you're getting all of your water from Gerald Steiner. You would have to have a very big water budget in order to do that.

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Lorna Nichols: Thanks.

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Breta Alstrom: Alright awesome. Thank you. Everyone. Dr. Doug has to go unless you wanna make me host. And I can answer any tech questions that people have

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