How (& Why) to Use Circadian Fasting


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This podcast is sponsored by Jigsaw Health, my source for magnesium. You probably know, if you’ve read my blog, that magnesium is responsible for over 300 biochemical reactions in the body. It impacts blood pressure, metabolism, immune function, and many other aspects of health, including hormones. It’s known as the master mineral and it’s one of the few supplements I take regularly. And I have found a specific way to take it that works best for me in very specific forms because if magnesium is taken in the wrong way it can lead to digestive upset or if it’s taken too quickly it can cause all kinds of problems. So, I take two supplements. One called MagSRT which is a slow release form of the dimagnesium malate. The slow release technology makes it easier on the digestive system. So I don’t get any of the digestive disturbance that comes with some forms of magnesium. I take this form in the morning and at lunch. So, two capsules with breakfast, two capsules with lunch. And at night, I take a different product MagSoothe, which is magnesium glycinate which is magnesium bound with the amino acid glycine to help sleep. And in combination, I noticed the biggest effect from those two particular products. You can check them both out and save by going to jigsawhealth.com/wellnessmama. And the code wellness10 will give you $10 off any order.

This podcast is sponsored by BLUblox. That’s B-L-U-B-L-O-X, which is an advanced light-filtering eyewear company. You’ve probably seen pictures of me on social media wearing orange glasses of various types at night. And here’s why. In nature, we aren’t exposed to certain types of light after dark, specifically, blue light, because that type of light signals the body that it’s daytime. That in turn suppresses melatonin and can interfere with sleep. This is the reason that a really dramatic study found that camping for seven days straight with no artificial light at all could actually completely reset and heal circadian rhythm and help a lot of light-related problems, like seasonal affective disorder. This is also the reason that I wear orange glasses after dark to block these types of light and protect my sleep, which I am adamant about protecting. I also wear certain types of yellow glasses and anti-fatigue glasses during the day if I want a computer to reduce eye fatigue. BLUblox has orange glasses and yellow glasses. Their orange glasses for nighttime wear are designed to block 100% of the wavelengths between 400 nanometers and 550 nanometers, which are the ones that are studied to interfere with sleep and melatonin production, and circadian rhythm. My kids also wear these kinds of glasses at night. And I noticed a difference in their sleep as well, which is a huge win for a mom. This is especially important when we’re watching a family movie at night or looking at any kind of screen as the artificial light, there is a source of blue light and can interfere with sleep. You can learn more, they have a ton of educational content and check out all of their innovative protective glasses by going to blublox.com/wellnessmama and using the code wellnessmama to save 15%.

Katie: Hello, and welcome to “The Wellness Mama Podcast.” I’m Katie from wellnessmama.com and wellnesse.com, that’s Wellnesse with an E on the end, which is my new line of personal care products like hair care and toothpaste that are completely safe and as effective as conventional alternatives. And this episode, I am so excited to have today’s repeat guest Dr. Amy Shah, who is a double board-certified doctor and nutrition expert, with training from Cornell, Columbia, and Harvard University. She’s also one of my favorite people to follow on Instagram @fastingmd. And drawing from her background in internal medicine and allergy and Immunology, as well as her own wellness journey, she has dedicated her practice to helping her patients feel better and live healthier, using integrative and holistic approaches to wellness. She has a list as long as my arm of accolades and awards but she’s also just a great voice for moms and women in health in very practical ways. And in this episode, we go deep on the idea of something called circadian fasting, which even if you’re not into fasting at all, it’s a very easy intro way to get into fasting with a lot of really profound benefits. So she explains how you can use this simple method as a method of anti-aging for a lot of aspects of health. She really goes deep on the research and how you can implement it. Really fascinating episode and I can’t wait to jump in. Here we go. Dr. Amy, welcome. Thanks for being here.

Dr. Shah: Thank you so much for having me again, Katie.

Katie: Well, your first episode was so popular and I loved our conversation that I knew I wanted to have you back on. And I have seen you posting so much right on Instagram and about one of my favorite topics that I knew we had to have an in-depth conversation about it and that is fasting in all of its forms, but specifically, circadian fasting which you are a big proponent of. So to start broad, can you explain what that means? What circadian fasting is?

Dr. Shah: Yes. So, I know Katie, you’re a busy mom. I’m a busy mom. And I know a lot of your listeners are busy in so many different ways. And I was trying to think of a way to incorporate intermittent fasting in my life that made sense into a busy life with a family. And when I found the science behind circadian rhythms, which is basically that every single cell in our body has a clock and if you can tune your body to this clock, everything works better: your gut, your brain, your immune system, your hormones specifically. So I’m combining the science of circadian rhythms with the science of intermittent fasting. And that’s what circadian fasting is. And so it sounds really complicated, but really, it’s super simple.

It’s basically not eating three hours before bed, and then going to bed, and then waking up and having breakfast and so there’ll be a break of between 12 to 16 or 18 hours between the last time you ate food the night before, and the first time you eat food the next day. And so it’s something that’s maybe a little stretch if you’re someone who’s a typical American who eats, you know, 15, 16 hours a day, but it’s not so much of a stressful stretch that you can’t incorporate it into your busy life.

Katie: Yeah, and I think there’s an important distinction here that we can talk about because this kind of lines up with the idea of time-restricted eating or time-restricted feeding. And I know, there have been a lot of studies on this by people like Dr. Satchin Panda, and others. And the data really is compelling when they look at time-restricted eating and different windows from eating in even just like a 12-hour window or an 8-hour window.

I know they’ve done research on cancer patients and all kinds of different scenarios and found that eating and even just a little bit shorter of a window is important, but I feel like circadian fasting is supportive in another degree as well, which is that you’re kind of timing this with the body’s natural rhythm, with sleep and with light in a lot of cases, because typically we’re sleeping when it’s dark. And so avoiding eating after dark and avoiding eating during that time. But what does the data say that you’re seeing about the benefits of time-restricted eating and especially in circadian fasting when you’re timing it with your sleep?

Dr. Shah: Yes, so great questions, and absolutely in the science, scientific literature, this type of intermittent fasting is really considered time-restricted eating or time-restricted feeding when it comes to animal studies. And so the animal studies have been quite robust. Dr. Panda is one of the lead researchers at the Salk Institute and they talk about it’s not, you know, just what you eat, it’s when you eat. You could feed animals, the same exact diet, but you restrict the time that they eat it in. And they have less disease than the animals who are eating all day and all night long. And it makes sense, Katie, because think about it, our bodies are set to have a metabolism time and a repair and renew time and because we can’t be doing everything all the time.

So there has to be a timing a time where we actually repair and renew. And the trigger for that for us is nighttime, and the trigger is no food. So for example, when your body senses that there’s no food coming, it switches on the repair renewal pathways, which we so badly need. But if you think about it, it’s like having guests all the time.

So if in a typical Western diet, we are having guests all the time, all day, all night until the very late into the night, sometimes 11, 12 midnight. So it’s like, how could you ever clean your kitchen, deep clean your house if you’re constantly entertaining guests. And so you think about it the same way, like if you’re constantly eating when are you ever gonna get to deep clean and repair your cell and that’s why they think that timing your food, as well as restricting your food and making good food choices are all equivalently important in long-term health.

Katie: Got it and I know it’s… I’ve done a lot of research kind of a deep dive into this as well in the past few years. And the research in general about fasting really is incredible and there’s so many different types, obviously. And everything from water fasting, which they’ve done studies with chemo patients on, all the way to just eating in a time-restricted window. And then, of course, everything in between. Are there any other benefits that we know from the literature on fasting in general? And can you get these same benefits from shorter-term circadian fasting versus a water fast? Or are there a time and a place for a water fast as well?

Dr. Shah: So you mean like an extended water fast versus kind of the shorter windows?

Katie: Yes.

Dr. Shah: So definitely there’s so many benefits of fasting for 24 hours or even I know you do even extended fasting like 3 and 5 days. And I think that the benefits of those are enormous, you know, because you really get into the autophagy zone, which is basically happening at all levels. It’s happening right now to you even if you’re not fasted, but it really ramps up at the 24, at the 48-hour, so there are life-lengthening benefits, anti-aging benefits, metabolism benefits that happen with longer fasts, but you can get so many of those benefits even with this shorter windows of fasting.

And so I think that what I was really shocked at was Ruth Patterson’s study which looked at breast cancer survivors, and they looked at women who had a history of breast cancer and had them do either like, you know, 13 hours of fasting or no fasting at all, just regular advice because they said, “You know, we wanna give these women who are breast cancer survivors, the least stressful activity, don’t want to bombard them with long fasts because they’re already possibly, you know, suffering in other ways.”

And so they did this short fasting intervals, kind of like what we’re talking about with the circadian fasting and they only fasted about 13 hours a night. And they saw over the long term a 34% decrease in breast cancer recurrence. And for me, that is enough to say, “Hey, you know, even in people who have not had breast cancer that has big implications for us as a society, because it’s one of the first big human trials, looking at shorter fasting intervals.”

Katie: Gotcha. And I feel like my listeners probably do have a pretty good idea, but for anyone who hasn’t heard the term autophagy before, can you explain that to us?

Dr. Shah: Yes, sure. So, you know, there is a process that happens in our cell. It’s basically self-cleaning of the cell. So when autophagy is happening and this happens in certain states. It happens with, you know, intermittent fasting can definitely stimulate it, exercise can stimulate it, heat stress can often simulate. So basically, what happens is, your body turns on this process or turns up, I guess I should say because it’s always happening at some low levels, turns up the process of cleaning up our cells. They take out the garbage, they clean out the cell. It’s actually like a self-cleaning method. And the reason why that’s so important, Katie, is that we know that when you’re looking at aging cells, they’re really not doing as much. Their autophagy levels are just lower and slower.

And as the cell gets older, it’s almost a way you can age the cell. If you look at a cell under the microscope, when it isn’t undergoing that self-cleaning process, it just looks older, not functioning as well as a younger cell that has a robust autophagy process. So if you can boost the levels of how much autophagy you’re doing on a regular basis by intermittent fasting or exercise, like why wouldn’t you do that? It’s like a free anti-aging tool that you can use because that cell, under the microscope looks as young as a younger cell. And you can imagine that there is actually no medication, no cream, no other thing that we have in this world that actually does that. So that’s kind of the very exciting part of autophagy. It’s not just for disease, but also for anti-aging.

Katie: Awesome, I think that’s a good segue too. So let’s talk about the aging component, because hopefully most people listening don’t have something like breast cancer or worrying about that recurring or a serious health problem. But fasting has a lot of implications in the aging process as well, from what I understand. So if someone is just looking to kind of age more gracefully, what can fasting do there?

Dr. Shah: Yeah, so just like I told you every skin cell, every cell in our body has a clock, even our skin cells. So the example of skin seems to hit home for women really well because if you think about it, our skin has cells that have clocks as well. And so what they found in a study was that, hey, if you eat late into the night, your skin actually ages faster, you have more UV damage because your cells never get a chance to do that cleanup process, that sweep kind of repair process.

And so you end up having less UV damage when you are doing time-restricted feeding or time-restricted eating, so circadian fasting, in other words. And so for women, less UV damage means less age spots, less wrinkles, and basically, you know, having younger-looking skin that comes from no cream, but comes from actually activity that you can do for free.

Katie: I love that. And so when you talked about fasting and especially longer fast, I wanted to have a note here specific to women because I know there’s conflicting advice about if women should do long fasts in general, and if so, if there’s any special considerations, and I’ll be the first to say that even though this is something I do relatively regularly, it’s not something I recommend across the board or to anyone.

It’s just I know, what works for me after a lot of years of experimentation. And importantly, making sure my hormones and my gut were both in a really good place before I started doing long fasting. But you mentioned there are some benefits to longer fasting, do you have any special considerations that you would give to women, especially if they’re considering that, and is this something you do as well?

Dr. Shah: Great question. So I am that person who tried, you know, longer fasting and failed and learned the hard way that it wasn’t for me, but that’s not to say that I won’t do longer fasting but what I tell women especially and not every woman, like you said, everybody’s very different, depending on your genetics, depending on your baseline health status, your gut and your hormones.

But for many, many women in childbearing age, they have a hard time with longer fasts because we think that our bodies, hormonally, are designed to protect against long-term starvation because we, you know, in the case of if we were going to carry a fetus, potentially, our body is protecting us, and turning off ovulation or turning off the ability to carry a baby, if it senses that you’re in starvation, or long term starvation. So what happens to many people and what happened to me and what could happen potentially we still don’t understand exactly is that you start fasting too aggressively for your own body, and maybe too fast and what you end up having is hormonal disarray.

Your body starts to turn off the signals for ovulation and then you get, say, a missed period or you get a longer cycle or you get an irregular cycle. And those to me are danger signs when someone is fasting that, hey, this is an alarm that your body is setting off that, hey, we don’t feel like your body is capable of carrying a child. And even if you’re not interested in getting pregnant, that’s a sign that you are going a little too hard on the fasting or a lot too hard. And for me, that actually did happen. I first, you know, started fasting really aggressively. First, I started, you know, 16 hours of fasting every day. And then like day three, I start to get really, really hungry and really tired.

So I tell people that that’s another sign, your hunger, your cravings, your mood, and your energy are great markers, non-invasive markers of how a health plan is going for you. If by day three, four, five, you are feeling exhausted, you’re having cravings, you’re feeling moody, your sleep is disturbed. That’s a sign you need to back off. But say you don’t listen to those signs, like I didn’t listen to those signs. And this happens to a lot of other women. And you just keep going and you’ve tried to even do more aggressive ones like 24, maybe 30, 48, and you notice that now, “Oh, I missed my period, I’m always usually at 28 days. And now, I didn’t have one for, say, 35 or I didn’t have one at all.” That, to me, is a sign that there is something off. The health of your cycles is the health of a woman’s hormones. It’s a sign. So that’s when I back off.

Now, there’s very few studies on this. There’s a couple of animal studies that looked at very aggressive, prolonged fasting in rat studies, and they did see a halt in ovulation. But I tell women, “Listen, this is not something that you cannot do just because, you know, at the extremes, it could be too aggressive for you. Just work yourself up.” So the long answer to your short question is work yourself up to that position, just like you mentioned, you really worked on it and you worked on working your body up to that point.

And so if you have been doing intermittent fasting or circadian fasting or anything, and for, you know, months and maybe years, and you want to try a extended fast, that is something that you could do in a crescendo fashion. So now I’ve worked myself up, so I do a 24-hour kind of a dinner to dinner fast, once a month. According to the research studies that were done on the Mormon population, they do a Sunday fast, and they have found enormous differences in cardiac outcomes in people who do that Sunday fast versus people who do not even when they try to control for all the other health practices that, you know, Mormon population may do differently than the general population. They still found that the Sunday fast was an independent item or independent activity that improved cardiac outcomes in that population.

Katie: Yeah, that’s a great point. And like you said, working up to it, I think is key. And like with any study, we can use studies for good kind of general information. But I’m a big proponent of at the end of the day, we’re all responsible for our own health and we find our best health when we figure out specifically what works best for us based on experimentation and genes and testing. And so if I’m doing a long fast, I’m definitely testing first. I’m letting my doctor know. I know my level is going in. I’m testing coming out to make sure I haven’t messed, interfered with hormones or hurt my thyroid. I’m very cautious of that.

And I know a lot of people like that seems like a lot and something I feel like I need to do if I’m going to do extended fasts and something not everybody necessarily is willing to do and that’s why I’m like, I don’t think long fasting necessarily is for everyone. But that’s why things like circadian fasting are amazing because you can get, like you said, not all but most of the benefits with much shorter fast like that. And I feel like it’s been a common theme in research and even just a lot of experts will say, you know, don’t eat late at night or don’t eat right before bed.

That’s recurring advice. But the research really supports that. Even if that’s the only change you make. Like you said, I feel like you get such a boost by not eating late at night. Are there specific guidelines that are helpful? For instance, like I feel great when I stop eating at like 5 or 6, like pretty early in the evening, even though I’m not going to bed at 8:00. Are there guidelines for helping figure out that kind of sweet spot ratio of how far in advance of either sunset or bedtime?

Dr. Shah: Yes, so I love how you’re phrasing it. There’s so many benefits of, you know, people will criticize me and say, “Oh, my God, you’re promoting this very unhealthy practice that’s restrictive.” And what I come back with them is, you know, actually what we’re doing as a status quo is the unhealthy practice, which is eating late into the night, telling people to eat every couple of hours. Like, that is actually the unhealthy recommendation. So not eating three hours before bed should be a standard recommendation for better gut health, for better sleep, you know, for better mental health.

And what I usually tell people is, when I work with people, I say, “You know, start with that, and do, say, 12 hours in the beginning, if you’ve never, ever, ever tried this before.” That would be a good spot to start. And, you know, of course, check with your doctor because not everybody fits into that category. But many, many people can start at the 12-hour point. So maybe it’s like from 7 to 7. And then, just like you’re mentioning, Katie, I am the same way, like, say you get used to the 12-hour thing and that’s still a big improvement off of what you were doing before. And then three days a week, you push that, so you may push that, meaning eat your dinner even earlier.

So maybe you decide with your family that, hey, we’re gonna eat a very early dinner tonight and, you know, this seems so crazy to some people and so doable to others. So it really just depends on your lifestyle, to maybe eat dinner at 5, or maybe end your dinner at 6, a couple of days a week, maybe non-consecutive days. And see how you feel in the morning. That’s when I think the magic really starts to happen is when you stop eating at 5 and then maybe you don’t eat again till 8 or 9 in the morning after a fasted workout. And that’s when you actually gonna get into that autophagy and into that metabolic switching zone. That’s when you’re gonna see even additional benefits from doing this kind of fasting.

Katie: And another area that I think I’m curious your take on so I’ve noticed I feel better when I eat lunch as my biggest meal because it tends to be higher in protein and just higher in food volume, which then gives me more time to digest all of that before bedtime, even though I’m still eating a smaller dinner. Do you know if there’s any research that backs that up, I know, in some countries lunch is the bigger meal and dinner is lower?

Dr. Shah: Yeah, I think that, you know, the research really does look at 12 to 5 being a good digestion zone. And, actually, very interesting because this is where Ayurveda, like, Eastern medicine and Western medicine kind of agree is to eat the bulk of your meals between that. Exactly what you just said, between the hours of 12 and 5, where you’re, kind of, you know, maybe eating a smaller dinner, and you’re eating a no or smaller breakfast. And that seems to be the kind of strongest digestion and that is something, like, I love when Eastern and Western medicine agree on something.

And that’s one of the places that seems to be really powerful and agree, so exactly when I described the circadian rhythm because people will say, “Give me some guidelines like some bumpers.” And I say, “Okay, well if you ate the bulk of your meals between 12 and 5 and then maybe stopped eating around 5 or 6, a couple of days a week, and then you’re stopping your blue light and I know you’re a proponent of this, too, say, you stop all the blue light 90 minutes before bed because this is all kind of circadian sinking. And as you know, one bout of blue light delays your melatonin by 90 minutes.

So say you stop everything, the blue lights, 90 minutes before bed and you just use, you know, either blue light blocking glasses or you just use no blue light, just a very soft yellow light or no light. And then you read a book, or do your skincare routine, or play with your kids, or whatever it may be to wind down, maybe there’s some meditation in that, and then you go to sleep ideally, say, 10:00, okay? And then 11:00 you get usually one hour after you go to bed, you get this huge burst of human growth hormone HGH, which is the hormone that repairs your injuries. That’s the one that everybody loves for skin and muscle repair and making you feel younger and more energetic, so you get that big burst.

So they call it beauty sleep for a reason because there’s actually is a burst. You get a second smaller burst right before you wake up as well or early in the morning as well. And so say, then you know about all these sleep studies that show that you have, there’s so much benefit in sleeping about eight hours. So you wake up, say, at 6 a.m. and what I recommend people do is get some sunlight. Get some sunlight, if you live in a place that even has some daylight between 6 a.m. and 10 a.m. go outside barefoot, if you can, get some daylight and really start your day in a very positive fashion. You will see your energy levels skyrocket.

If you can fast, do a fasted workout before you break your fast even better. So that’s kind of like rough goalposts throughout the day. And I tell people listen, I understand people have different schedules, you know, you may work a night shift, I get it like this is not supposed to be, you know, right for 100% of the population. But if you’re someone who’s like, “Hey, I want some goalpost to figure out how to do this, and try it for my own body,” that would be something I would suggest.

Katie: Yeah, I love everything you brought up. And I think just two important things to echo and to go a little deeper on, the first being, like eating in that shorter window and not snacking. I feel like a lot of adults will sometimes consider that advice. But then they’re hesitant to not give their kids lots of snacks or to not just feed kids whenever they’re hungry, even if it’s late at night.

And so I’m really curious your take on that as a parent because I know, from the research I’ve read at least, even any break that we give ourselves from digestion is really beneficial like you said to the liver, and in so many other ways, including during the day. So while we think we only eat 3 meals a day, when researchers actually look at it, most people in the U.S. eat up to 17 meals a day, because every time we ingest even just like a mouthful of food, our digestive process starts. And we don’t really give our bodies a break from that. So I’m curious, how do you navigate this with your kids and are there any other considerations?

Dr. Shah: Okay, so let’s be honest, Katie. During quarantine, it’s been like a total snack/eating fest in our house. And we had to really curb that exact problem is that, you know, when you’re home and you have access to food, you have access to the kitchen all the time, there’s a tendency to really snack a lot more. And you’re right, in the American culture for children, especially there is almost not more than two hours that go by without someone eating something. And so what I have roughly done with my own kids, and I think it really depends on the age of your children. But what I’ve done is…my kids are 10 and 12.
And they do really well with kind of a 12-hour fast, which basically is not like a stepping stone.

But basically, what we say is after dinner, they have a dessert. And we allow dessert after dinner as their dessert-of-the-day kind of thing. And then they don’t eat anything after that, until the next day. And that way that kinda gives bookends to the day like I always say, we’ll save it for dessert or…you know, because they’ll be asking me for a snack or sweet snack and they’re like, so innocent, these children, of course, for them, their taste buds are going to be lit up. Their brain is going to light up when they eat a processed sugary snack. And so they’re going to want that much more than a piece of fruit, for example.

So the way I kind of navigate around that instead of saying, no all the time, I say, you know what, if there’s something, like, a homemade chocolate dessert that you wanna have, you save it for once you finish your meals for the day, and then we’re gonna basically stop for the rest of the night. So they eat their one snack or whatever dessert after dinner, and then they’re done for the night. And the reason why I say 12 hours is a good benchmark is that it’s basically three hours before bed, and then they wake up and they can eat breakfast again. And that’s, you know, with growing children, you always want to weigh the risks and the benefits of a lot of this stuff.

Katie: I definitely agree. And I also love that you brought up light. Because I think this is an area that we’re just starting to understand the research on and people are kind of finally coming around to, but it can be really, really dramatic. And I think it’s easy to discount because unlike food, we don’t feel an immediate energy boost, or we don’t necessarily feel the immediate change from changing our light habits. But over time, I’ve seen the results of this in my lab work and certainly in my sleep quality and in my kids’ sleep quality.

So I think this is a big one for parents that you touched on. And I’d love to go a little deeper on it because, like you, we’re big fans of the morning sunlight as a family, and I’ll drink tea or coffee outside, often, non-caloric, so I’m still in that fasting window. But that makes a huge, huge difference in sleep both for adults, and especially in kids. And I know for parents, like anything you can do that makes your kids sleep better, you wanna know. So talk a little bit more about how we can use light to our advantage, especially hand in hand with this type of circadian fasting.

Dr. Shah: So exactly what you said, you know, sleep is at, you know, every time I read the research on sleep, and I know that your audience and my audience is so in-tune with this. And we’ve heard all the benefits of sleep ranging from the brain benefits, the gut benefits to the hormone benefits to the, you know, there’s just benefits on benefits. But there’s, children especially, are sensitive to this light, dark cycle. And I think that what we do wrong as a culture is, you know, we don’t do morning sunlight outdoors and get nature time. And then we don’t have an evening wind-down routine. And then the children, just like us, are wound up at bed. And just like I said, you know, one bout of blue light.

So one show in the evening is delaying their melatonin release by 90 minutes, and you need that melatonin release to actually feel sleepy. And so what I usually recommend to people and what I do myself is that about, you know, calculate 90 minutes before their bedtime, and then that’s when the devices and everything turns off. If you do, you know, allow them to have that depending on their age. And then maybe you do an evening routine, just like the adults do an evening routine. My children have an evening routine that they do, and maybe that includes a little bit of reading. Maybe that’s a little meditation practice, maybe that’s just, you know, talking softly, going over your day in the darkness.

And it’s so crazy, Katie, that this is like weird to people. Because, you know, if you think about it for hundreds and thousands of years, that’s how life was. I mean, until, what, smartphones didn’t even come out till, you know, I was in college. I think I started using… No, actually way later than that. It was computers and email that we started using in college. And then so you can imagine that it wasn’t too long ago, that turning up blue lights was standard because there wasn’t, you know, it was really just the TV that you could be using. So we really need to reset the way we, you know, set up our kids for the night so that they can get a restful sleep as well.

Katie: Absolutely, yeah, I think that’s so so important. These little things can make a huge, huge difference. And also when it comes to light is the issue of vitamin D and sunlight. And I would love to hear your take on this because I know that the research shows that vitamin D levels are really important for a whole lot of aspects of health and that it’s not just a vitamin, it’s actually a pre-hormone.

And right now, of course, we’re seeing data about vitamin D being important for good outcomes with upper respiratory infections. We know it’s tied to the immune system. We know for kids and hormones, it’s vitally important and that you definitely don’t want to have very low vitamin D levels. And I’m a big fan of getting moderate sunlight for this reason and also testing vitamin D and supplementing, if necessary. But it seems like you are also a fan of getting sunlight in appropriate amounts and vitamin D through the sun, but I’d love to hear your take on that in detail.

Dr. Shah: Katie, you summarize it amazingly well. Honestly, because I think that what you have to understand is vitamin D is an immune modulator. And that’s a fancy way of saying that it works with the immune system. It works like a hormone. It works in a way that we have not seen any other vitamin work. In fact, when I was in immunology fellowship, it was hormone of the year, because of its effects on the immune system that we’re finding out now are huge. And I do believe that much of the population has a vitamin D deficiency.

In fact, the correlative studies on COVID and vitamin D are very, very interesting. So what they found is that when you looked at vitamin D levels, the people who were deficient, just had very, very much different course of COVID than people who had adequate D levels. And so not only did we know that it stops you from getting respiratory viruses, but it’s sure that it can improve your outcomes once you are infected. And so that has been really interesting in the situation, but we know that it works like a hormone.

So if you’re trying to balance your hormones, vitamin D is imperative, testing your levels is imperative. I do believe, again, like you in getting moderate sunlight and so what people may say is like, “Okay, well, like how do you weigh this against the dermatologist recommendations of sunscreen all the time?” And so what I do for myself and, you know, it’s not perfect, but this is what I like, is if I can get a chance to do sunlight in the morning, which I do most days like you do, I go out without any kind of sunscreen or anything, basically first thing in the morning and get that morning sunlight.

So it’s really good for my circadian rhythms, get a little bit of vitamin D, and then start my day. And then, you know, later in the…if you live in a very hot place like I do, like, you know, the afternoon sun is quite strong in summer. So that’s when I’m wearing sunscreen and not spending more than, you know, 10 minutes bathing in the sun. So that’s basically how I couch both sides of the story here.

Katie: Got it.

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Okay, so if you don’t mind, can you take us through… I know you’ve kind of mentioned parts of your daily routine. But for you as a busy mom and a doctor and someone who is up on the research and understands circadian fasting and implements all of this, can you kind of walk us through what a day might look like? I know there’s no like average day, especially right now. But just kind of some of the things that you do daily in what order?

Dr. Shah: Yeah, great. So let’s start with waking up. So I wake up about 6:00 and I did that because I trained my body to start to sync with circadian rhythm. So naturally, I wake up around then. I will go barefoot outside. And I know not everybody has the opportunity to do this. If you live in a high rise, you’re not gonna walk out in your pajamas like in barefoot so just keep in mind that obviously you can change all of this or some of this. So I walk outside if I can, get a couple of stretches in the sunlight, sometimes I will do my gratitude right there. So it’s done for the day. Gratitude statements changes everything even if you just name two or three things you’re grateful for, especially around this time where mental health can really suffer.

And so but you can say, “You know, I know this is happening to me, but I’m so happy to have my health and the health of my family. And I’m so lucky that I have a home to sleep in, and a home to be, you know, quarantined in.” So then I go inside and I get ready for the day. And usually what that means is a workout first. So then I’ll get ready in my workout clothes and my sneakers and I’ll go, if I can do a nature-based workout, I will do that. So there’s studies, Katie, that show that rhythmic exercise is really, really calming for the brain. So rhythmic exercise is like walking or skating or swimming. Something that, you know, you develop a breathing rhythm and a movement rhythm.

It’s almost like moving meditation and so I love to incorporate some of that into my day if I can and I try to do it fasted. And first thing in the morning in nature because, you know, as moms we love to multitask, and this is like getting all of those things in one. And so then after that, I will usually shower and then break my fast and usually when I break my fast I break it first with water throughout but with a tea and nuts. And the reason why I do that is that whenever you’re breaking your fast you don’t wanna like immediately eat a huge meal. And this is more important when you’re doing longer fasts, but I also think that in general I just made it a habit of kinda starting with a smaller meal or smaller snack, I guess I would call it and start with the tea and nuts and I just kind of kinda go slow with that.

And then I will have my full meal. And my full meal in the morning is really not that big. It’s usually a deconstructed smoothie because right now I got sick of having smoothies. So it’s really just berries and veggies and nuts. And what I do is I take it with me to work and basically, you know, I’ll have it. I’ll have the berries probably on the way to work and I’ll have some of the other stuff throughout a little bit in the morning. And then I won’t have anything until about 12 depending on when I break the fast. You know, sometimes I’ll break the fast. Say, so if I’m giving you a typical example and I woke up at 6:00, and I started working out from 7:00 to 8:00, then I’ll break my fast at 8:30 or 9:00.

And I do that because there is some evidence that if you’re trying to maintain muscle mass or trying to build muscle mass, you can time your protein kind of one hour after you break that fasted workout to retain some of the benefits of weight training. And so I do that. And my protein will be something like usually a plant-based protein either black bean sprout, or tofu hummus, or it could be a…sometimes if I’m in a rush it will be like a vegan protein shake or a chia pudding, something like that.

And then I’ll have, I always, always plan to have two big vegetable-based meals a day. So usually it’s at 12:00 and 5:00. And the reason why I do that is because there’s so much benefit in feeding your gut bacteria, prebiotic fiber, so fibrous foods, especially from vegetables can be transformative to your gut health. And, you know, gut health is immune health. And gut health is hormone health. So that’s what I do for those meals. So it could be a stir-fry, it could be a soup, it could be a salad, but something plant-based, vegetable-based, I mean, and very, very heavy on the vegetables. And then I will come home from work and spend time with the kids. And I usually, what I do is about 8:00, I will really, 7:30, 8;00, we really turn off all the blue lights.

So all their computers, iPhones, everything around 7:30, 8:00 go off. And so everybody knows they can’t text me after 8:00 because I probably won’t answer till the next morning. And so I know that if it’s an emergency, they have the home line or whatever. So then basically, that’s when I do my wind-down routine. So the kids have a wind-down routine, I have a wind-down, my husband has a wind-down routine. And then we basically wind-down, I do my skincare, I do my prep for the next day, do a little more gratitude or a little meditation if I can, and then it’s lights out at 10. And that way I know I’m getting about eight hours of sleep every day. So that’s kind of a rough outline of the day.

Katie: I love that. And I love that you mentioned gratitude and just kind of bullet journaling a couple few things a day, I think that also makes a much bigger difference than we ever can anticipate just to shift our mindset like that. And I know you’ve also posted something on Instagram that I loved recently, “That which you don’t change, you choose.”

And I feel like, you have so many great quotes about focusing on the positive and focusing on the things we have the ability to choose and to impact which, especially right now seems ever-important of, you know, because we can feel so uncertain and so helpless at times, but yet, we still all have the power over things like this. Like when we eat and what we eat and who we spend time with. With our family, you know, whether we go outside in the morning. There’s so many small positive changes that we can make that make such a big difference. And I love that that’s your focus in so many of your posts.

Dr. Shah: Yeah, and I think, Katie, and right back at you because I honestly really, really can relate to so many of your posts. They are so thoughtful. And I think that what I’m trying to tell people is what works for me. Like, I was in that dark place once and here’s how I got out. And, like, right now with this whole, you know, COVID thing and quarantine, I also struggled a lot in the very beginning because what we don’t know makes us anxious, like the future and the past are what our anxieties come from, right?

And so what I had to do for myself is I had to say, “I need to focus on what I can control.” And so that’s what I was sharing with people. I said, “Hey, you can control only you and your own practices and your own habits. And if you would do that, that will take your anxiety level way down and bring your happiness level way up.” Because as soon as you finish the task of, say, going outside in the morning and getting some sunlight, as soon as you finish the task of like, hey, I finished my meals at 6 p.m. you feel accomplished, you feel like you are controlling your environment and you feel good about that. And so anxiety goes way down and that’s what I found was so helpful for me and that’s why I share with a lot of people online, too.

Katie: I love that. I’m curious, just on a personal level, any supplements or like beauty routines or things that you’d give advice to women especially?

Dr. Shah: That’s a good question, Katie. I am so anti-supplements only because I just hate having to think about a million things in the morning to take, and so I’m very big on minimizing how much you take every day because these are all things that are modulating your body that can be best done by food. But if for targeted practices like for example, you know, melatonin has been really helpful for me to shift my sleep schedule. So if you’re someone who is thinking about trying the circadian rhythm and trying to get back on track and you’re just so off, you don’t even know where to start, I would say, “Hey, maybe you try taking melatonin about 90 minutes before you want to go to sleep and maybe you just take one milligram,” because most, you know, store-bought melatonin is at very, very high dose and so or you use another kind of natural sleep remedy, chamomile or something like that.

You try that before bed to kind of reset your rhythm and I do that every time I travel or if I’m off schedule because of, you know, other things going on. And I do love vitamin D as we discussed. That’s one of the only supplements that I take on a regular basis. And then I like adaptogens like ashwagandha, I like amla, I like Rhodiola. Because I feel that when you are in the situation, there are certain points in your life and you may be in that point right now where your life feels like you’re doing everything right, but you really need support on the stress-control hormone balancing aspect, that’s when these adaptogens can really be helpful. And I do use them from time to time when I’m in those states.

And that’s really what I’d actually use when I was in my own kind of dark place and I had to take my health back to a different level. I am a fan of omega-3s, but I’ll be honest, I’m not so great about taking them all the time. I really try to eat a very, very good diet and hope that I’m getting, you know, at least some of that from there. And then other than that, sometimes I take magnesium, which is a nice way also to calm the body down in the evenings. Something like a natural calm or whatever. And then, during this time, there are lots of people who’ve been asking me like, “What about vitamin C?” And I am a huge fan of vitamin C.

And I think that if you’re someone who wants to boost up or support your immune processes, and you’re doing everything else, right, and you wanna add some vitamin C, I think it’s a very safe supplement because vitamin C is one of the vitamins that you can pee or poop out if you have too much. Like, there are some vitamins A, D, E, and K where you can overdose because your body is not capable of… It basically stores in the fat instead of being excreted. But vitamin C is quite safe and can be taken at very high levels. And once your body doesn’t need it, you’ll just pee or poop it out and that’s it. So during this time, a lot of people have chosen to do that and I think that is definitely something that’s valid.

Katie: I love that. Any advice just kind of, you know, and when this airs hopefully we’ll be in a little bit different of a scenario right now. But just from like mom to mom, any advice in navigating this kind of constant changing dynamic with families and with all of that brink of health and for just how we interact?

Dr. Shah: Yeah, you mean social aspects or just in general?

Katie: Both. I feel like people are kind of in a definitely increased stress right now, just because of, and when you said uncertainty is one of the biggest factors in stress. So is loneliness. And so a lot of us are having to navigate like isolation plus extra time with kids plus extra chaos. Anything that you’re finding that’s helpful?

Dr. Shah: That’s a great question. And I think from mom to mom, I think my children are in the same situation. I think that being outdoors and, you know, the calming effects of nature has really transformed us and every time someone asks me what to do is get outside, go for a walk, move your body, be in nature, you will feel so much better. And the other technique is that gratitude is like practices with your children like, hey, isn’t it so great, you know, aren’t you so grateful that you’re able to go for a walk right now? Or aren’t you so grateful that you can still learn from home and you don’t have to attend school? And really flip the script so that you’re not always talking about anxiety-producing things.

And now, in the beginning, this is so bad. But, Katie, we would watch like the news every evening, because we were, you know, all of us were in the state of like, constant change. And there was so much going on that we would just like, watch the news. And then, of course, after like, a week of that it got really old and really anxiety-producing and I couldn’t sleep well even if I’ve turned off the TV way before bedtime. And so what I realized is, hey, I need to compartmentalize and only consume the news when my mind is mentally ready for that. And so I only do it like twice a day now. And because for me as a physician, I need to keep up on the science and the literature. So twice a day I check in on what’s going on in the world. And then I don’t look at it after that.

Katie: That’s a great point. I think I’ve had to limit. I actually have done that for probably a decade now. I just like limit exposure to the news and to most aspects of the media. And I realized I am not any less informed about the world or like, the world hasn’t ended, because I’m not aware of all the things going on at all times. And my stress level is dramatically less. And I think right now you’re right, that such an important point is in whatever way it works best for us individually, like limit the sources of that because all of them are stressful right now. There’s always so much uncertainty and we do have control over what we let in and I think that’s a really, really important point.

Dr. Shah: Yeah, I think it makes your mental health better. And, you know, honestly, I think that, for me, I get so much more from discussions with really educated people. And so what I’ve been trying to do is having some real-life phone, or FaceTime, or online discussions with people who are very, very well-versed, so you get the benefits of relationship and get the benefits of conversation without having that scary kind of anxiety-provoking headline of the news. And that’s what I’m trying also when I do my Instagram updates. I try to be really like as if a friend is talking to a friend instead of being like attention-grabbing and anxiety-producing with my headlines.

Katie: I love that. And then lastly, as we wrap up, I know I need to respect your time, you’re a busy doctor, but are there any books, podcast sources of inspiration for you right now that are helping you keep things positive or that you’ve just read and loved lately?

Dr. Shah: Oh, that’s a great question. So I have really, really loved a new book. Have you ever heard of David Goggins?

Katie: I don’t think so.

Dr. Shah: His book is “Can’t Hurt Me” by David Goggins. And it is so, so inspirational because it’s talking about someone who really went through a lot of struggles in his life. It’s kind of a biography. And it’s been so inspirational to me because I just look at his life story, and it really gives us perspective on how to be strong. It’s almost like a combination of biography and self-help. But I really, really have loved it. And I know you love reading, so that’s a great one. It’s right up your alley as well. I love your podcast and I think it’s a really great source of information. And that David Goggins’ book is really life-changing, you should check it out.

Katie: Awesome. I’ll make sure that is linked in the show notes as well as your website and your Instagram, which I’m a big fan of like I said, I follow it. But I really appreciate you being on. I hope this encouraged a lot of people to consider circadian fasting, which I think is the perfect, gentle intro into fasting. And if even if that’s all you ever try, like, Dr. Amy, explained, there are so many benefits. I would love for you guys to give it a try to let us know how it goes on Instagram or in the comments. But, Dr. Amy, thank you so much. I know how busy you are. And it’s truly an honor that you’ve spent time with us today.

Dr. Shah: Oh, Katie, thank you so much for having me on. It was an honor and pleasure.

Katie: And thanks as always to all of you for listening and sharing your most valuable asset, your time with both of us today. We’re so grateful that you did. And I hope that you will join me again on the next episode of “The Wellness Mama Podcast.”

If you’re enjoying these interviews, would you please take two minutes to leave a rating or review on iTunes for me? Doing this helps more people to find the podcast, which means even more moms and families could benefit from the information. I really appreciate your time, and thanks as always for listening.



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