Why Snacking All Day Is Making Indians Fatter and Sicker | Time Restricted Eating Explained

Why Snacking All Day Is Making Indians Fatter and Sicker | Time Restricted Eating Explained

Author Name:Dr Pal

Youtube Channel Url:https://www.youtube.com/@DrPal

Youtube Video URL:https://www.youtube.com/watch?v=FCfGAPLj2bw



Transcript:
(00:00) Normally when you have a meal, have you seen children? They'll eat a meal and they'll go running. Adults, they'll eat a meal and they want to go to sleep. So you eat and then you go to sleep. But that's just not true. Eating the food is very sacred. You have to be in a parasympathetic state. You should eat over a 20 to 354 minute window, [music] not under 15 minutes.
(00:22) >> Dr. Nisha Chelum doesn't just treat patients. >> She teaches them to understand their own bodies. Her work in integrative medicine >> empowers people to take control of their health from within [music] >> for circadium rhythm to maintain. Is there a particular time that you would recommend? >> If you wake up at 6:00 in 2 hours break your fast your exercise part is somewhere between what I find most people tend to do is they talk about their stress over and over and over again. The [music] most important thing
(00:50) when it comes to stress in women as they get older is to find the right partner. If you're not married well, you cannot manage [music] stress. Really, the one thing that I tell my 30 yearear-olds now, we're building your body for your [music] vibrant 80year-old self. So, I think yes, our lives are busy, but we're [music] not fueling ourselves to handle that busy life.
(01:13) >> Fuel is food and sleep. >> I would say five pillars of health, right? One is >> before we dive in, can I be honest with you? It blows my mind that 57.9%age of you who listen regularly still have not subscribed to our channel. If you enjoy the podcast, the stories, the signs, maybe even laugh at our jokes.
(01:33) Could you do us a small favor? Hit that subscribe button. [bell] It takes only 2 seconds and helps us keep bringing you better guests and episodes every week. I'm truly blessed to have all your support and I'm sure you will support me in the journey. Now, let's get into today's episode. Hello guys, welcome to another episode of our podcast series gut feeling with Dr. Pal. In this podcast we have Dr.
(01:57) Nisha Chalam. She trained in India, went to US and got trained in MD general medicine and she has been seeing patients for the last 30 years. She strongly believes in lifestyle medicine and we address the root cause of all the problems which is metabolic health. Dr. Chalam is a metabolic expert and she has treated so many patients with so many non-communicable diseases including fatty liver PCOS, hypothyroidism, elevated cholesterol levels, you name it.
(02:23) So we have discussed all the processes, problems and the solutions in this podcast. I want you to take a pen and a paper jot down all the notes during the podcast so that you can start implementing it right after the podcast ends. Let's dive deep into it. So Dr. Nisha, what is metabolic health and why should we worry about it? Okay.
(02:42) So when you talk about metabolism, it's how your body processes energy, stores it, uses it and it should do it in such a way that you don't have any disease or discomfort. That is good metabolic health. And why should you worry about it? Literally metabolic health can determine how your quality of your life. >> You may not die because of you know poor metabolic health.
(03:08) U it's not like um of course heart attack is a part of metabolic dysfunction. >> However, before you have the heart attack, metabolic health begins so many years before. >> It just decreases your quality of life. >> The energy because it's it's all about how your body utilizes energy. >> When someone says, "I'm fatigued. I'm tired at 2:00. After 2:00 I'm useless.
(03:32) Or if I wake up in the morning, I need a cup of coffee." That's all metabolic health. and that's affecting your quality of life. So I think it's very important to take care of it. So when someone feels fatigued in the morning, >> it is an indication that the metabolic health is not >> there is something yes is there some degree of inflammation that's ongoing in their body right and they don't have so fatigue is where your body is not creating enough energy that you can utilize it right so question is unless you're starving you should not be
(04:03) fatigued like I you have no food but if you're eating why are people who are eating on a regular basis so fatigued That's because that energy that they've eaten, that food has not been converted to energy that they can utilize. >> And we need to get to why that's happening in an individual. >> Uh how do we know that this is not working? >> So let's say you have a meal.
(04:31) Normally when you have a meal, have you seen children? They'll eat a meal and they'll go running. >> Yes. >> Adults, they'll eat a meal and they want to go to sleep, right? They're tired. um you know um what what do they say that um orang >> yes >> right so you eat and then you go to sleep >> but that's is not true that is the bogging down of your metabolic machine because you've overeaten so every time you have that fatigue following of a a meal and then or within an hour of eating a very good meal you're hungry again or you're you feel like you don't have
(05:12) energy and you need to eat something I need my glucose I feel is going down these are all metabolic dysfunctions so why does that happen that's a whole thing ours discussion why that can happen right >> so when you feel tired or when you feel sleepy uh people think that you know I'm just exhausted and maybe my body needs more rest >> got it >> but the body needs more rest is an individual subjective evaluation uh based on the amount of energy that is being produced in the body and you're saying that that could be a mismatch.
(05:47) >> That could be right. But you know when you say when you come to the conclusion you're exhausted you have to ask yourself what did you do to get exhausted >> like did you go hunting for food? >> Have you not eaten? I mean there's there should be a reason for exhaustion >> but in this fast-paced environment everybody feels exhausted because you know have kids to take care of you in a family hard working.
(06:12) >> Yeah. Yeah. >> That is not considered as an exhaustion. >> No I I don't think that is that would be exhaustion is people are exhausted on waking up. How do you get exhausted waking up? Like if you've been in bed for 6 hours or 8 hours why are you waking up exhausted? So yes, we have a lot more on our plates. I agree.
(06:35) I think we have less support >> than we had before. Um especially women, I will say they have a lot of flying plates >> and they have to balance everything. >> So the question is, is there is there a way I mean we're not there is chaos in your life, but there's also metabolic chaos in your body. And the metabolic chaos in your body, you can actually handle it if you're fueling it right.
(07:04) And the question is how do you fuel it and how are you fueling it? >> Fuel is food and sleep. >> Food, sleep. So there are I would say five pillars of health, right? One is nutrition. >> Very important. Equally important is movement. >> Most of us are sitting almost 8, nine hours in front of the computer.
(07:25) We're not moving. I I mean I have I have a trainer and the biggest argument between me and him is my 10,000 steps. I barely hit the 10,000 steps on the days that I have long clinic days. I don't have the time to get that. So that's movement. The third one is how you manage stress. People live right now medicated.
(07:47) Whenever somebody says, you know, I have uh three kids to take care of, I have a job. I I need an anti-depressant. and I need an anti-anxiety. It's just a form of st there's a difference between a disease process like depression or inflammation of your brain and you handling day-to-day activities. Right? So stress, how you handle stress.
(08:10) Then comes the sleep. How deep and how regularly do you sleep? And then the community you hang around with. So if you have friends where you go and say, "Oh, I get migraine headaches once a week." Oh, I get it every day. That's not the kind of friend group that you want. You want a friend group that >> kind of inspires you to get better.
(08:33) >> We seem to be bogging each one down with, you know, more problems like my problem is worse than your problem kind of a thing. So, your community is very important. So, if you have those five pillars and you take care of those five pillars, you will no matter how busy your life is, you will actually have enough energy to do the things you have to do.
(08:52) >> Wow. Out of those five pillars based on your experience which one you think that Indian community or most of us are lacking? >> You know the one thing the Indian community has is great community >> right? they are they especially like in a place like US or outside of India >> they gather together whether it be in the temple or the have church or the parties whatever they have that's one thing that they've got down but that's also their problem >> because what happens when you meet it's samosa pakora >> lots of you know biryani stuff like that
(09:28) they you're constantly eating high calorie food three or four times a week >> where the Indian community really strugg struggles is the nutrition part. >> We are eating like our ancestors but we're not moving like our ancestors. >> Keep in mind the India is in a tropical climate closer to the equator. >> The food and our life like if I think of how my life was growing up, I used to catch two buses to go to college.
(09:58) I had to walk a lot. I was sweating all the time. So when I come home, eating carbohydrates was just fine. >> But then I moved to a country like the US where I'm in air conditioned environment. I'm barely moving. I'm not um you know I get into a car, get in and out of um places and I'm still eating the same carbohydrate.
(10:20) How is that helping me? Right? So I think for the Indian community, yes, they don't want to leave their culture, but then they need to take the whole culture with them. they're only taking part of it which is the food part. The movement should be there. The cooking at home should be there. None of that is getting um transferred.
(10:39) So I think nutrition is a huge part. The other part that I think the Indian community when I see my patients the one I struggle with the most is movement. >> Every Indian wants to walk. >> I walk every day doc. I walk three miles. I walk five miles. But if you look at what where the Indian community is lacking is they don't have muscle mass.
(11:00) We are the tophi right thin on the outside fat on the inside people >> that is because we don't build muscle >> and to convince an Indian man or a woman saying stop trying to lose weight try to build muscle that is a whole big conversation >> because the nutrition should be higher in protein.
(11:24) I think the Indian uh what do they call ICMR >> ICMR right they spoke about how we are um >> carbage >> carbridge but they called it a specific one where we are nutritionally deficient even though we're abundant in our uh calories we're nutritionally deficient >> correct >> it's really the protein requirement is 12% to 15% we're not even hitting that >> we're not hitting our vegetable kota like 2% or something and we're instead of you uh much higher number.
(11:54) >> So our food is very carbri comfort food. >> We're not moving. We don't have the muscle mass to utilize that energy. And I think that's getting us to be metabolically unhealthy. A big percentage >> of us like I don't think there's any Indian um in their mid4s and 50s who's metabolically healthy today.
(12:18) I can almost say guarantee unless they are lifting weights or they are into fitness. >> Let's say a person listen to this podcast and then understands about metabolic health and they feel like their metabolic health is very low and everything and they want to work on the five pillars that you're talking about. >> How long does it take on average if they take a new year resolution now? >> Yeah, it also depends on the consistency.
(12:38) >> So again, I'll take myself as an example, right? when I went through this process did my genetic testing I found that I don't metab I I don't um process milk very well >> and a south Indian if you take away yogurt you might as well end life as as much uh because we finish every meal with the yogurt rice right I mean how do you finish any meal >> so it took me four years to actually start quit dairy >> um it took me a long time to understand that I don't need rice three times a day.
(13:15) >> I'm not utilizing that much energy. >> So, it all depends on how well educated you are, how motivated you are, >> and how consistent you are. I have seen some patients who dramatically change in 90 days. I don't even recognize them because they put in so much of effort and they're able to sustain.
(13:35) So, I feel it's the mindset. But the other thing also very important don't get connected to the end result which is like people will say I want to lose weight >> but why do you want to lose weight you need to say that why do you want to lose weight and what do you want to lose weight for like is it to resolve a disease to look good if you want to look good why do you want to look good is it for a wedding is it or you know there's you you need to connect to the purpose but in in general what happens is if the motivation and purpose is very strong
(14:17) >> you are very consistent because this is important for you like like um I'll say somebody in my age they'll say I want to play with my grandkids >> that's a very strong motivator >> that might be good that's that gives you long-term lifestyle changes right But when you say I want to go for a wedding and we've seen this a lot of times people lose weight for their wedding and soon after the wedding they gain all that weight back.
(14:43) >> So that is not a good goal right if goal is health you have to create changes that are consistent and that are permanent. >> That's why diets never work because diets are not permanent. You have to make a shift and say it's like um the best example I give is I I don't know if you've had um any Jewish friends.
(15:10) They don't eat bacon, right? >> Yes. They don't. >> Yeah. Even if they've had bacon before, once they adapt that they decide that I'm going to be an Orthodox and I'm going to be very very much true to my religion. They don't touch bacon even if they like it >> because that identity is there. You have to identify.
(15:28) Health should be your identity. M >> the problem with the Indian community disease becomes their identity. They say I'm a diabetic. >> I'm a hypertensive. >> Once you start identifying with your disease, it's very difficult for you to shift your health. >> But if you say I want like if you look at it, we have pink ribbons, we have fundraisers, we have walks, we have triathlons for diseases.
(15:53) Who is running a triathlon or fundraising? If somebody says I want to become strong and healthy, no one >> it's all [snorts] on you. >> So as a community we celebrate disease. We will do fundraising for disease. We will talk about disease and we think of getting healthy as a lot of work because it is. M >> and so the best way is to raise awareness with your children that health is non-negotiable because you can be if you look at that they you've seen that saying um a rich man can have a lot of desires but a sick
(16:35) man has only one >> right and once you have disease people will be willing to give anything to get back their youth their vibrancy so focus on health, stop focusing on disease. So, but then that's the other extreme also. People come to me and say, I don't want to take any medicine. >> I have high blood pressure.
(16:57) I don't want to take I want to naturally cure it. So, what does naturally curing something mean? It means you have to change everything that you have been doing that created the blood pressure in you today, high blood pressure. >> So, are you willing to do that? >> That's what is overwhelming. So I feel that's where we're failing because uh we want to feel healthy, we want to get healthy but we don't want to do the work.
(17:27) That's called the mismatch between the input goals and the output um requirement. >> Right? If I want to lose weight, I have to be willing to forgo the samosa. But I want to have the samosa and I want to lose weight. That doesn't work. But let's say a person listen podcast you know they are have been struggling with weight issues for a long time or they are diabetic or they are PCOS the disease has kicked in and let's just come to the baseline that Indian community we have not prioritize our health first and we have compromised our health because we have successful
(18:00) careers >> yes >> right so we have taken health for granted and eventually the disease hits it >> okay whether you like it or not >> uh let's most common thing is that you know they go to the PCP around the age of 40 years and uh they get the blood work and your glucose level is slightly high.
(18:18) They diagnose you as pre-diabetes or they diagnose your fatty liver. >> When some kind of disease happens like this and you beautifully mentioned about the motivation and purpose, the motivation becomes I want to get rid of this fatty liver. I want to get rid of the diabetes, right? How do the patient actually internalize the motivation? what are the things that they should do so that the motivation stays longer even after resolution of the diabetes? >> Yeah.
(18:48) Yeah. So I first of all I like I said your purpose has to be very um uh very solid. So for instance um now since I've had aging parents my mother's 92 one of the things I've learned from seeing aging as both in a profession and on a personal level at some point your life becomes what they call the marginal years. >> You're not as independent as you would be.
(19:17) you're not able to do all the things that you want to do and to some degree you're depending on your family members in the Indian community. I mean this that notion that your children will take care of you. Of course that is going away as with the new newer generations but the older generation believes the children have to take care of you. >> The motivation should be at no point in your life should you be a burden to your kids. So that's one.
(19:44) The other motivation I mean I don't know why like when somebody says I don't want to be a diabetic. Okay that's good enough motivation and once the diabetes is gone how do you stay on that path you will stay on that path if the changes you made were permanent changes. >> See the problem is when you like if you just say I want to lose 10 pounds and you lose the 10 pounds after that what >> right? So your your purpose should be a little more indepth >> than just saying I want to lose weight.
(20:18) I want to resolve my diabetes and I want to stay diabet diabetes free for the rest of my life. What do I need to do? What are the changes I need to make? So once again you have to change your identity towards I'm a non-diabetic >> and when that is your identity you all the lifestyle changes you make will be supporting that.
(20:41) M so I don't think I I think motivation what you're talking about and what we seen commonly is this short-term goals quick and get the result and once the result happens >> there's no other purpose for it correct >> and they slide back to their old habits >> which means those changes that they made were temporary and difficult >> can you can you say an example >> so let's say um uh a south Indian for instance >> stops eating rice completely That is not practical in my opinion.
(21:13) >> Right? >> So you'll do that you can do it for 6 months you may even do it for one year. >> Uh in fact there have been studies where uh Indians were put on a keto diet for two years and the minute they went back to carbs >> literally they had fatty liver >> right be so it's not feasible for you to give up something that is very close to your heart but you moderate it.
(21:38) So you don't go on any crash diets. You see how can I if if somebody if a dietitian is working with me, I tell them my non-negotiables. I tell them I want to eat rice. I want to eat rice at least two or three times a week if not every day >> and if if I want to eat a grain, what are my options? You have to have those conversations >> and make it like a more permanent change in your lifestyle rather than doing something acute, painful >> and so restrictive that you snap and you go back to your old ways.
(22:11) >> That's why hypoc calorie diet restrictive diet may not work for a long time. >> That's correct. though it is the most efficient [snorts] and the most effective uh treatment it doesn't because we live in a world of abundance and this is where the practicality of trying to stay healthy becomes um you know really a challenge because when you look at in the past most Indians had diseases of uh scarcity >> not enough vitamins not enough food da da da all of that now we have diseases of abundance >> too much stress not enough walking like
(22:47) too much sitting, too much food. That's what we are. So, we've swung the pendulum. And in order for um um for us to um create that long-term health path, you have to look at what your specific goals are, what your lifestyle is, what what you can live with for the rest of your life. >> Like, I can eat one day millet, I can eat one day quinoa, and one day rice.
(23:15) I'm okay with that. Then that's how you design your life around that. >> Wow. But that was wonderful. [snorts] That was really good. Uh but I just wanted to um piggyback on that discussion where um so let's say a person listening to this uh have an idea about okay so metabolic health is bad. >> Yeah. >> And I'm getting into these diseases or they are feeling that weight is very difficult to come off.
(23:40) >> Yeah. >> What should be the next step? Is it blood work or which comes first in terms of metabolic health? >> Yeah, I because I do functional medicine. For me, testing is a huge part of why functional medicine is so much fun. >> I always recommend elaborate testing. So, for instance, uh you go to a conventional doctor, they'll do a fasting blood glucose and A1C.
(24:08) >> A1C may be like 5.4 and they'll say you're fine. But if you don't check the insulin level, let's say for that 5.4 your insulin is actually 20 >> at in the fasting state, that is a problem. So I actually recommend testing to see is am I catch can I catch this disease early before your A1C snaps >> and gets higher.
(24:32) M >> so yes testing would be the first step >> to understand what your problem is and understand how uh deep the problem is. >> And you briefly mentioned about tophi right so thin on the outside fat on the inside >> and uh we always talk in medical literature that that might be one of the uh risk factor for increased heart disease among Southeast Asians especially Indians.
(24:57) >> Can you just explain what that tophi means? >> Yes I can. So there's something called personal fat threshold. >> So when you look at uh you've you've heard this body positivity movement where people say you can be healthy at any weight and there may be some truth to that because some people can carry on be 200 250 pounds and not have any metabolic disorders.
(25:27) They may still be able to exercise. They may have a lot of energy. they do they'll have perfectly good blood sugar numbers. So they have a fat threshold where they can accommodate a lot more fat cells. >> So the analogy I normally give is say you um you watch a home and garden TV show and you want to buy furniture. >> You have a small New York apartment 500 foot. You love all this furniture.
(25:57) You buy this furniture but you have no place to put it. You stack them and then you put them against the walls. The walls get damaged. >> Everything around in your house gets damaged. It becomes nonfunctional. That is the person who has a very low personal fat threshold which is South Asian population.
(26:18) We don't accumulate weight on the outside. People look at us and say, "Oh, you're normal weight." But we're accumulating weight inside our organs. Mhm. >> And when the organs get like pancreas and the liver, then your hormones and all of the metabolic processes that happen, these these organs are not functioning well.
(26:38) So in that instance, what is happening is you're not noticing it, but every time you eat food, your sugar is going all the way up. Your insulin is going all the way up. there's lot of inflammation that's happening because the body is not able to process all of these things because everything is not fun nothing is functioning >> right and it takes a long time for that sugar levels to come down and it's in the meantime it's doing a lot of damage >> so where you accumulate fat is very important so people who can have a lot of weight and not have disease they're
(27:13) the ones who have this big mansion they're also buying a lot of furniture but they have enough rooms to put the furniture in so it doesn't look bad but at some point they're also going to get crowded out but their their uh runway to get to the disease is a little longer because they can accommodate that much that many calories >> whereas most of us in in South Asia we accumulate more of the weight in our organs before they we accumulate it uh under the skin so we have the disease first before we look like we have the
(27:43) disease >> ah so there is this uh adipos tissue hypothesis where the fat cells the central ariposity surrounding the belly button. >> Yes. >> The fat cell size is much smaller. >> Yes. >> For Indians compared to the other community. >> Yes. It's a hypertrophy and hyperplasia, right? If you can produce more fat cells, you can accommodate more.
(28:04) >> But when you cannot expand and you snap like that's why the liver cells get damaged because the fat is accumulating. >> That's when [clears throat] you land up having a lot more. And fat cells are not >> just fat cells. They're not just storage sites. They are active endocrine organs that are producing hormones, hormones of satiety.
(28:26) So the leptin, your brain doesn't listen to leptin anymore. So you don't know that you're full and you're overeating all the time, 30% more, >> right? >> So that's the big Yes, that is a huge challenge on >> when there are more fat cells being deposited, the leptin response is uh curtailed. Correct. >> Yeah, they actually the leptin starts um the there's a lot of inflammation first of all, right? And then when the leptin uh goes to the brain, what they find the brain doesn't listen to it and again there's a genetic component to it how
(29:00) your leptin receptors will connect to the leptin hormone and it's almost like you have less your your brain cells become less responsive to leptin. So the satiation signal, the fullness does not hit your brain. So one of the things I tell my patients to do is to chew your food down to a liquid. >> Take time to eat.
(29:23) When you want a second helping, normally we say wait 20 minutes. I tell my patients to wait 40 minutes before they go for the second helping. And by then >> second helping a second serving >> second serving of the food they'll find that they don't want it because that it's slower the signal to the brain saying yep you've had enough food is much slower when you have a metabolic dysfunction.
(29:45) >> Sorry to interrupt but I really need to say this about my mission and passion. I've spent years reviewing almost every weight loss program all over the world [music] and the problem is the same everywhere. Most programs treat weight loss like a 30-day challenge, not a [music] lifelong transformation.
(30:02) That's actually why I created New Me [music] using the same science and structure I use for myself and my patients in California. Because real lasting change never [music] comes from one diet plan or one gym coach. It comes from having the right team [music] around you. In new me I have put together actual doctors, clinical dieticians, [music] life coaches, mental health therapists, sleep specialist, physiootherapist and a 24/7 virtual gym [music] with yoga, zumba, strength training and aerobics all in one place. And if you're someone
(30:32) who have tried everything and nothing [music] has truly worked long-term and you're looking for a lifetime change, Numei is for you. But a small request, don't join if you're looking for a quick fix. This is for only people [music] who truly want to transform their health for good. This is my mission.
(30:49) This is my passion. [music] If I change one person's life, I know I'm changing the whole family. Link is in the pinned comment. Now, let's get back to the podcast. >> But we don't have 40 minutes to >> that is a problem. Yes. But but also when you look at how people eat, they they literally breathe their food in. Have you seen people eat in 5 minutes? You spend 2 hours cooking and I find people are finished in 5 minutes and they're gone. Right.
(31:15) So I think that's a that is the underlying problem is how we how we prepare the meals and how we eat the food. Eating the food is very sacred. You have to be in a parasympathetic state. You got to chew. You got to take the flavors of the food and you should eat over a 20 to 354 minute window not under 15 minutes. >> What does that do to the body? So first of all it gets the whole digestive process working.
(31:47) So when does digestion begin in your brain >> like if you think of um let's say my most favorite dessert used to be tiramisu >> if I think of tiramisu my mouth will water. So you're beginning the digestion there and mouth has saliva has all the enzymes the amalayise and all of those things. So your your digestive process once the food gets broken down your energy absorption is much better >> rather than when you're doing half chewing digest digestive juices have not come because you're in a sympathetic state then you get these undigested food
(32:20) going down that causes dysfunction of your gut bacteria now you have gut dispiosis you have bloating you have constipation >> everything gets disrupted so how you eat is as important as what you eat. >> So your bloating and constipation can be backtracked >> into how you eat as well. >> Oh yeah, absolutely. The veagal nerve.
(32:42) >> So how you eat, what you eat and when you eat? >> When you eat. >> Yes. >> Out of these three, which one do you think the most important? >> I know all three is good. >> I think they're all they may be equally important, but I I really focus when I think about how I speak to my patients, I tell them um eat in a parasympathetic state. How you eat is so important.
(33:04) >> I don't want I don't want that, you know, I don't want you to be driving, walking and eating, driving through, you know, going through the drive-thru and eating >> or looking at the phone, >> looking at the phone, watching a movie and eating, not focusing on the food, but that's when you eat more >> because it's more of a boredom at that time.
(33:21) >> Correct. >> Um rather than actually uh uh eating. So, first of all, you should have a same spot you eat your food in like your dining table. It should not be the spot where you're uh paying your bills >> that yeah the eating place should be very sacred. You only eat food there and you eat in a parasympathetic state.
(33:43) So even if you buy pizza, >> sit down and eat it calmly. And when you chew and eat, the satiation signals will reach because you're taking 20 minutes to 30 minutes to eat one slice of pizza. Very rarely will you go for the second slice. M >> right >> so the problem happens when all this three goes wrong. >> Yes. >> And a lot of times where when one goes wrong all three all >> all three goes wrong as well. Right.
(34:11) Right. uh how you eat the chew your food 32 times >> right because you have like the >> who has the time right [laughter] >> but when you do that yes >> I think the parasympathetic nervous system kicks in digestive is even better >> and indirectly the gut lining there is decreased gut dispiosis everything falls in place >> correct >> in the worst case scenario while you eating your favorite ultrarocessed food >> that is correct and now the other thing also I've this is something I learned when I was um as a part of functional
(34:43) medicine when you're chewing your molars. It actually helps your cognition. >> So you the chewing process is so important. That's why I'm not a big fan of smoothies. People will always ask me, can I have a smoothie or a soup? >> You don't like smoothie? >> Yeah. I I don't I don't because you're just drinking it, right? So I tell my patients to make a smoothie with some pieces of fruits in them or nuts.
(35:04) So you're chewing your smoothie, too. >> So you're almost eating your smoothie rather than just drinking it. You need to have the chewing motion to get the digestive process started. So the mechanical motion of the mouth is as important as the biochemical uh version of digestion. >> Wow.
(35:25) It starts a syphalic phase of in the brain >> syphalic. Yes. >> And then you're mechanical and then it goes down. >> So it's it's an it's a it's a miracle. >> Totally. [laughter] I mean it's it's just an amazingly complex process. But if you really understand it, you will respect your food. You'll respect the eating time. >> Wow. >> I I'm one of those I cannot eat in a hurry.
(35:48) If I don't have time to eat, I would rather skip that meal. >> I know that's not good either, by the way. That's not a good advice, but I'm just saying because eating should be it it should be a glorious moment in your life. >> So, I'm very curious. You're a very busy practitioner. So, you block your time for eating. >> Yes, I do. >> I do.
(36:10) I my my schedule includes eating and exercise. It's every day. It is there in my uh clinic schedule. >> Give me an example like 12 to 1 you block. >> Yes. I'm I'm blocked from 1 to 2 and then I'm um every day I am blocked and that I actually make my food and I eat it around that that time. >> And then no phones? >> Nope. >> I don't see patients.
(36:33) I don't see my office is downstairs. I go upstairs to eat. So, >> how long you been doing this for? >> So, I've been uh 2011 is when I got exposed to functional medicine. I would say from 201617, I've had slowly evolved. These practices have evolved. For the last few years, it's pretty much how I like to do things. >> And your Hashimoto's under control.
(36:55) >> Yeah, actually I'm not on any thyroid medicine. >> You're not on any thyroid medication? >> No. >> That's not a common thing for Hashimoto's patients. >> Yeah. But so most people come with Hashimoto's too late in the disease where they thyroid is completely destroyed. Mine was caught reasonably early. >> So I've experimented with going off several times.
(37:16) I couldn't go off because my thyroid would get out of control again. But I've learned the biggest management for me was my stressor. >> And of course my two kids have graduated now. They're independent. So I have less stress in life. And which is another thing I want to tell the women out there. It's so important. You have to acknowledge life is stressful.
(37:36) So give yourself grace. It's okay. You don't have to be perfect. But just put in little bit effort >> and eventually you have to learn to manage your stress. And once you learn to manage your stress, your your body begins to heal. >> No, I had a lot of questions but I'm really focused on the stress [laughter] because I think you have mastered it I would say. So tell me about this.
(37:59) So what does stress do to our body in terms of digestion, metabolic health? >> Yeah. Yeah. So when you look at stress, your body has the body's in a fight or flight mode, right? >> So we have this chronic cortisol that is a little uh offbeat. So cortisol is cyclical. It's rises in the mornings, goes smoothly down and towards the night it's almost a flat line.
(38:26) But a lot of times for us, cortisol is up and down, up and down throughout the day. So there's a lot of fluctuation in glucose and inflammation. So whenever you're chronically stressed, you're chronically inflamed. When you're chronically inflamed, it's like um having a traffic jam, nothing goes through your hormones, they cannot signal properly because the receptors there's too much inflammation.
(38:52) So signaling is gone. Stress is altered signals to your body >> and the body is in a chaotic mode and it doesn't respond normally. >> So unless you know how to handle stress and I keep saying handle stress it's not so simple >> because I find most women the reason they're stress is so out of control they're doing a lot of things on their own.
(39:17) >> Sometimes their spouses don't help. So it's really creating that community where you find that help and then that way you can reduce your cortisol levels, you can reduce the inflammation, then your body can actually see the signals >> from the hormones function. >> Uh I mean I'm just going to summarize that for what you said.
(39:37) So let's say PCOS so estrogen and progesterone are not talking to pituitary properly or not working with ovaries properly. So this if you backtrack could have happened from a stressful episode in the past or in during regular elevated cortisol levels. So when we decrease the cortisol levels the hormones talk to the cells better.
(40:00) So the ovelation everything can happen in a much smoother way is what you suggesting. >> Yeah that is correct. But stress is of three different kinds right. It could be food can be stress. So it can be uh just food. >> Food can be stress as well. Yes, your mental stress is another stress. So it's called physical chemical um and physical stress would be injuries that can be a stress and then you have the biochemical which can be your food and then you have the emotional stress.
(40:27) So you have three different categories of stress. >> But what we were thinking was only the emotional stress thing, right? >> Yeah. So I find food is a huge stress for the body because if you're giving it all the wrong nutrition all the time, it's >> it's a stress >> constantly stress because it's not getting the nourishment it needs.
(40:45) >> Wow. >> Yeah. >> I've not thought about it that way. So let's say you were eating a pizza once a month. It may not be that much amount of a stress. >> That is correct. But let's say that you know lots of ultrarocessed foods on a frequent basis or maybe how you eat also gets disturbed >> everything right so it's 21 meals a week if you just say three meals a day 21 meals a week >> 18 to 19 of them should be good quality but most of us eat five good quality meals that's where the problem is >> when you say good quality whole foods
(41:18) >> whole foods cooked at home stuff like M majority of us were car walking out with a bagel or a muffin in the for breakfast. Lunch we get something from the cafeteria and dinner might be something that's homecooked and sometimes it will be carry out right so when I actually talk to my patients I can count three or four times in the week that they eat really good nutrition.
(41:42) >> So you count the meals what they eat. we actually have a conversation about it >> and they also begin to realize that's why I tell people when you're always stuck. Use the apps like My Fitness Pal or Carbon or Chronometer or whatever you like. >> Use them and see for yourself how much are you eating.
(42:04) Cuz I the first time, you know, years ago when I first started using it, I used to tell myself, I'm eating tofu. It's so healthy. >> And I remember putting this tofu dish. It was 780 calories. This is just I didn't even finish the whole thing. I just put what I ate and it was 780 calories. We don't think it's going to be that much.
(42:24) Each meal can be around 500 calories. I would already exceeded and this was my last meal of the day and I already had about probably,000 calories before that. >> So you you don't realize how you're eating because you're eating mindlessly. >> So that mindful eating is probably the most important thing. The second thing is the food that you eat should actually nourish your body and turn on the right genes cannot drive inflammation.
(42:51) >> The problem is most of us are eating food that drives inflammation. >> And so it actually bogs you down and brings your energy down. >> Can you add something about the genes? What does food do to your genes? >> So um so I'm trying to see how to explain this. So there was a recent study uh on ketones. >> They they're making now exogenous ketones and they they've been making exogenous ketones for some years now.
(43:18) But now we understand how the ketones work. Before it used to be like oh ketones help you lose weight. But what the ketones do, they actually go to the genes, specific genes that uh increase fat loss >> um or promote um lipolysis and you actually lose weight when you take exogenous ketos.
(43:41) So a lot of your food will actually help your those signals the hormones to work well. Your metabolic rate will shift your um inflammation will go down. Mind you, every time we eat, we do get inflamed. But if the better the whole food, the more whole your food is, the less duration of inflammation. >> So your genes actually get activated by the nutrients that you consume.
(44:09) >> So if you want the right genes to get activated, eat better good quality food. The polyphenols, the different fruits and vegetables, different colors. um eat seeds, nuts, the good types of fats that will actually they're also signaling. They signal your uh cells. When you start eating that way, you'll find food gives you energy does not make you feel tired.
(44:32) >> Your input on how do you manage your mental health or in terms of stress through the mental angle. [laughter] I I will say the the most important thing when it comes to stress uh in women as they get older is to find the right partner. If you're not married well, you cannot manage stress. >> This is something that I've learned over the years.
(45:01) So, I'm very grateful I have a fantastic husband. >> So, I think that's half the thing. Like a lot of times when you have a very supportive family, you have less stress. But in general, when I get stressed, one of the things I do is I actually go quiet. >> I'll take some time to figure out why am I stressed.
(45:21) I actually write things down on a board and see how do I handle this. >> You do? >> Yeah. >> Because you you know there um this is one of the things I I used to go to a lot of these motivational talks with Tony Robbins. He will say you should always have three options for a problem and after you find the three options, find a fourth one.
(45:40) [laughter] So it's like I always keep that in mind whenever you have a problem you have there is always a solution >> you just have to figure out what is the solution which has the least amount of um what do you call um um downside to it right because sometimes the problems can always come I mean the solutions can come with their own problems >> correct >> so you've you have to sit down and solve the problem What I find most people tend to do is they talk about their stress over and over and over again >> and then they're re rewiring their brain
(46:16) to talk about their problems but they never talk about solutions. So there's a rule you talk about your problem once and that's it. After that you only talk about solutions. But if you keep talking about the problem all the time it becomes more than it is. >> Wow. >> So that's something that I've learned over the years.
(46:38) When you say talk about like talking to yourself, >> talking to everybody. >> Everybody, >> whoever they call, [snorts] they'll say, "I'm overwhelmed. I'm overwhelmed. This is what has happening. My work is like this. It's so toxic." They're constantly talking about it. >> What are you doing about it? >> If your work is a problem, change.
(46:55) >> You have that job because you have some skills. Move. >> Don't stay in a place and keep talking about it. I mean, to me, first of all, working is a privilege. Not everybody gets a job and when you get a job, don't complain about it. Make it work for you. >> I know it's easier said than done, especially when we see in medicine the burnout of doctors and nurses.
(47:16) >> Correct? >> But I always tell people if you've identified that your job is a problem, change it. Do something. Either you change your attitude towards your job or you change your job. >> But don't keep talking about it. Then if you're talking about it like with your friends, your family and everybody, it just has become a big problem that you feel is not surmountable at this point because you've made it so big. Right.
(47:42) So I think don't talk about a problem more than once. >> Wow. Um you know I'm so glad that I'm talking to a medical doctor about these kind of issues because this is the main thing that is actually making the patient not getting better. >> Yeah. And I always feel that you know especially a patient walks into my office any GI problem there is always an underlying stress issue >> always 100%.
(48:08) In fact when a woman comes in with multitude of problems back ache shoulder pain migraines guaranteed she's not having support in her life. >> But you cannot bring that up unless they are willing to talk about it. M but you know you practice in the US and you have seen Indian setting as well. >> Yes. >> You would be the best person for me to ask.
(48:31) >> You see a lot of you know divorces and marital uh uh problems among the white uh Caucasian family. >> Uh is it getting common? It it is getting common among Indian community as well. >> Um watch a person listening to this podcast. what should they actually work in case let's say that the marital support is not there or they want to work on it have you seen any patients like that and uh just a thought on that >> yeah I I really think this is a conversation right many times in the Indian community unfortunately or
(49:05) fortunately it may be an arranged marriage so you had no choice >> in how you found your partner >> but I think a lot of times so I I the kind of people I meet are a little more educated, >> we do have these conversations. It's almost the same inertia >> to make the change, >> right? Whether it be going for counseling.
(49:31) >> Um, that's another thing with big taboo in the Indian community going to a psychologist or therapist. But it's also getting better. I feel like more people are open to therapy. >> Willing to. Yes. >> Yeah. Willing to go. And I think you have to first make that decision. Do you want this to work? And if you've made that decision that you want it to work, then you do everything within your power to make it work.
(49:53) The problem is people don't know if they want it to work. They they don't make decisions. I think the indecision is the biggest problem I see in life. So when you identify a problem, first of all, make a decision that you're going to solve it >> and or you want to solve it. Sometimes you might be like, "Oh, this this is over.
(50:13) This this doesn't work for me on any level." And that's okay, too. And then you make that decision. And I always tell my patients, create a plan for an exit if things don't work. But if you decide it's it >> to be in there >> to be in that relationship, make it work. >> Figure out a therapy session, talk to your spouse, involve some friends, but try to get to make it work.
(50:37) Most of the times we tend to withdraw and become silent and just live in that toxic environment. And I think that's that manifests as diseases in us. >> Ma'am, you should come back again for the podcast [laughter] just on this separate angle as well. So moving on to fatty liver. We talked about tofi thin on the outside, fat on the inside.
(50:56) Um you know there's been increasing incidence of fatty liver. I what I see in my patient is that if the waist circumference is more than you know 80 cm in females and 90 cm in women I nowadays don't even do any blood work or don't even do any ultrasound because we know there's some kind of a fat deposition in the fat liver >> u how big is that a problem in your practice and what is the uh outlook that we have to look at from this problem >> yeah so fatty liver is really um it's becoming so common you're seeing it in young people very very early people who
(51:31) don't drink alcohol >> and a lot of times you'll find that um the solution is very simple right I'm I think um like I mentioned to you you it's like piling all this furniture into a small room >> um so the best solution for that is remove all that furniture out so I always tell my patients give the gap between your meals >> so that's The most important thing we are if you're waking up um you're eating breakfast then at 11:00 you're having a biscuit and tea then you're having lunch then you're having a rusk and tea and
(52:09) then you're having like a dinner and then a bedtime snack >> that's a lot of calories for somebody who's probably sitting and watching TV or in front of the computer right >> you need to give time for the liver to empty so I'm a huge fan of fasting >> or time restricted eating. >> If you're not if you're not going to the gym, let's say it's a non- gym day for you.
(52:34) If some people like to only exercise two or three days of the week, let's say it's a non- gym day, I would say just reduce your meal intake to two meals a day. >> And the last meal, try to have it very early because as we all know, the stomach begins to detox around 7. the lining starts renewing liver at 8, brain at 10 and the liver again at 3:00 a.m.
(52:55) So for all that process to happen, there should not be any food. So stop eating at 6:00. Unfortunately, in India, they start cooking at 8:00 p.m. >> Right. >> Right. And then you're having your dinner at 9:00, 9:30. So there's a there's a little mismatch in the cultural uh norms. So I will say trying to time your meals to eating earlier when your insulin is most sensitive is the best way to reduce your incidence of fatty liver.
(53:24) So timing of the meals and the uh quantity of the meals how many uh how many meals do you have in a day so if you can if you can skip dinner I think that's would be the best if you have fatty liver >> and in my practice I'm a big proponent of time by feeding as well. So, I have made multiple reels on how you should not eat anything after 7:00 p.m.
(53:43) and that's why my followers count went down. >> That's [laughter] true. >> So, uh but the first thing that the patient tells me is that hey, you know, I listen to you. I had my dinner at 7:00 p.m. But at night, 11:00 p.m. 12:00 a.m. I'm getting this hunger. >> Drink water. >> Water.
(54:06) So this is more um this is a more uh habit for the body right if you eat as a certain time the stomach begins to growl you're not going to die because of hunger I tell my patients I promise you 3 days you'll be hungry fourth day you'll be fine so it's almost like a practice um it's um >> actually not that I hope you don't never dice but uh sleep so what they're saying >> oh the sleep gets disturbed yes if I I'm hungry I am not able to sleep properly.
(54:35) That is correct. So I say you know you drink water you wait for 20 minutes. >> If it is pure thirst because most of the time thirst manifest as hunger then it'll go away. If it is hunger then it will persist which means that the 700 p.m. dinner was not enough in [snorts] fiber and protein is what we say. >> That's usually what I tell them to do.
(54:56) Yeah, if you're not sleeping, that means the last meal did not have enough protein and did not have enough cal fiber. >> Fiber. >> But if you do carbohydrates, you'll again wake. Most people wake up at 3:00 a.m. because their blood sugars drop because they're very high carb. They do last meal. >> Say that again.
(55:12) >> So around 3:00 a.m. is when the liver dumps the glucose, glycogen breakdown. So if you've eaten a very high carb diet, you've had insulin overwork [clears throat] and so it makes your um sugar go all the way down. So you actually have hypoglycemic episode. >> So if your dinner has enough protein and fiber, you'll tend to sleep better at night.
(55:38) The other thing you have to keep in mind is most people it's a more psychological >> they've been eating so much and they feel like oh my god if I don't eat I I cannot sleep. I have had a lot of my patients say that then we try to work with them. I'll tell them drink a teaspoon of olive oil before bedtime because that doesn't spike your insulin.
(55:58) something once I start doing that they eventually that goes away that issue goes away with sleep and then this they'll come and tell me I don't know why I was fussing so much this is so easy I really love >> timerestricted eating right makes I feel more clarity I I'm able to think better I have more energy >> so I think the inertia and the initial apprehension that oh my god if I don't eat I'm not going to sleep I think it's valid >> but there are solutions you can work around and if you work with a good nutrition coach or somebody who's a
(56:31) trained in functional medicine they would be able to guide you on how to overcome that >> come that so the night meal is very important if there somebody's practicing time feeding >> I am very big proponent of it >> of that right so let's say 7:00 p.m. eating for dinner. >> Um, you would recommend at least 30 grams of protein in that meal.
(56:50) >> Yes, >> I would say the breakfast and dinner should have at least 30 g of protein. I love 40 grams if you can get there, >> but 30 to 40 g of protein. Definitely about, you know, 15 g of fiber and uh chew your food down to a liquid. Take some time to eat. If the whole digestive process is taking place, it's going to take the whole night to digest your food.
(57:15) >> And do you think this is a nuance uh to this uh discussion? Do you think that we can convince the patients to eat around 7:00 p.m. provided we say that you know you can have a lot of quantity. Sometimes what I feel is that they're saying that you know you are asking me to limit the quantity >> and >> and also the time as well.
(57:34) Then sometimes I say that you know why don't you start with the time first? What is the is there a drawback to that approach? >> I do I you know when you look at all the circadian rhythm studies they do say your insulin resistance is the highest in the evening. So when you're giving a very big meal at that time you actually will tend to gain weight.
(57:53) >> So it's a very nuanced conversation with the patient right is it the sleep or the weight and all of those things. And most people I find when they say I'm practicing intermittent fasting, whatever that means, >> they're eating the biggest meal in the uh at night, right? So I the question I ask them is when you're going to on a long distance driving, >> do you fuel the car at the destination that you reach or when you're starting? >> And they'll say, "Oh yeah, I'm going to fill the gas tank before I go." And
(58:22) that's what you need to do for the day. >> Always have a nice robust breakfast so that you don't need that 11:00 snack. >> Mhm. And if you cannot if you skip lunch also that's fine and then have a dinner. >> But if you're going to have a robust lunch then you can actually make a dinner as a smaller meal.
(58:40) The problem is people skimp on everything >> and then in the evening they come sit down and say now I have the time and they piling on everything. It's exactly like how in your work 5:00 you have to leave to go pick up your kids and then your boss comes and puts 10 files on your table and says now finish all this work before you leave.
(58:59) >> Yes. >> Why do you do that to your body? >> Cuz the body is saying we're going to go to sleep. Why are you giving me all this? So I'm just going to put it in storage because I don't have time to process it. >> Wow. So So for fatty liver we talked about basically no snacks in between meals. >> I I would not recommend any snacks.
(59:17) I don't think anybody needs snacks if they eat properly. >> And why is the snack concept came? Because of uh uh energy requirement during the day. >> I honestly don't know who created a snack. First of all, I don't even know who created the breakfast concept, right? I there's a lot of theories and stories about it.
(59:35) But I think in the if you look at our ancestors, they were all farm farming. They would eat before sunrise because they had to go to the farm and they would just that was the only time they ate and then they would eat when they come back home. M >> I don't know where the concept of snacking came. It could be very much a British um practice maybe.
(59:54) >> So snacking actually stimulates the insulin levels frequently. >> Frequently yes. So each time your insulin is comes you're storing fat. >> Yeah. >> Especially in fatty liver patients. >> In everybody. >> In everybody. >> But yes and more in a fatty liver you have far more insulin resistance. Right. Fatty liver is just a symptom of in insulin resistance.
(1:00:15) It's just a continuum. There are medications for fatty liver. [laughter] >> Do you believe in that or you just think that lifestyle medicine itself will be able to decrease? >> Fatty liver is 100% reversible. >> Yeah, >> it all depends on the patient. Right. I have patients who will see me and they'll see their uh conventional alopathic doctor though I'm an alopathic doctor.
(1:00:37) It's just I don't necessarily I don't go for the medicines as the first option. Right. >> They they will choose whatever is easy for them. That's what I found. If they find like, oh, I can't do all this diet, exercise, and sauna, and everything, I'm just going to take the medicine. If that's what it's going to do for me, then that's what I'm going to do.
(1:00:56) But again, you're just putting a band-aid. At some point, maybe you'll solve the fatty liver for the moment, but something else will show up. That's what people don't fail to recognize. >> You can solve one problem with the medication. Um, why does the same person have diabetes, high blood pressure, and cholesterol? because it's the same disease process and you're just controlling the sugar but you've not controlled whatever is the underlying cause and now that thick syrupy sugar is very difficult for the body to move it so the pressure goes
(1:01:29) high you then controlling the pressure you're causing damage to the blood vessel wall now the cholesterol particles will accumulate their rest plaques now you have cardiovascular disease all the same process because you're not addressing the underlying cause which is overeating, sedentary lifestyle, smoking, whatever that might be that is a trigger in you [clears throat] >> for the disease.
(1:01:51) >> Wow. So, uh timing between the meals is important. Timing of the last meal is important. How does sleep play a role in this? >> Oh my god. Sleep is such a huge part, right? [laughter] So, if you don't sleep, what has been shown is that uh your grein which stimulates your appetite goes up >> the hunger hormone.
(1:02:13) hunger hormone goes up, >> your leptin goes down, there's more leptin resistance and your insulin resistance goes up by almost 25%. >> So all of your hormone signaling gets distorted when you don't sleep. So sleep we find that's the time when the lizoomes the janitors of the body they take out all the inflamed cells this out of Fiji happening they're replenishing the nutrients.
(1:02:41) If none of that is happening, you have gunk accumulating. >> So again, you have inflammation. All the hormonal signals gets disrupted. The studies show you accumul you eat 200 to 300 calories extra every day when you don't have sleep. >> So imagine if you do 300 calories every day extra, that's about 9,000 calories in a month extra.
(1:03:06) >> There's your weight gain. >> Right. Right. Right. Right. uh for circadium rhythm to maintain is there a particular time that you would recommend? >> So uh the only one that I know of is Dr. Sachin Panda's work. >> Yes. >> Yeah. So his um what he mentions is try to if you wake up at 6:00 in 2 hours break your fast and your exercise part is somewhere between 2 and 4 p.m.
(1:03:36) I think is the best in the afternoon >> and your last meal should be at 400 p.m. which I know is not practical. So, I negotiate with my patients like you do, 6 to 7:00 p.m. if you can finish off your last meal >> and make it the lightest meal of the day and have a really robust lunch. So, if you can do that, break your fast 2 hours after waking and try to finish wrap up everything before 6 p.m.
(1:04:00) , I think you will be in reasonably good metabolic. >> And sleep is around like 10 p.m., 11:00 p.m. >> So 10:00 is when the detox of the brain happens. So I usually tell my patients 9:30 if you can get to bed. >> Okay. >> Um it gives you that half half an hour latency to go to sleep. >> U sleep also is another process, right? Your bedroom should be cool.
(1:04:20) There should not be TV in the bedroom. It should be at a lower temperature. For me it's like 67°. What is that here in >> 23? >> 23, right? So 23° >> and your sheets should be cool. You should be cool. So, if you're not very cool, go have a quick cold shower. You don't have to put soap. Just cool your skin.
(1:04:42) Or sometimes you can have a hot shower because that'll uh radiate >> all the heat out and cool. The internal body has to cool for you to go to sleep and everything. You can't get on the computer or watch TV, news, and then go to bed, right? On the phone >> or on the phone. Yeah. Scrolling. All of that should have been done 2 3 hours before bedtime.
(1:05:02) So, your brain knows you're shutting down. And then lights >> all the overhead lights should be shut down. So because we don't have >> sunset as such it's always bright in our world. Correct. >> So the brain needs to know that yeah it's time to sleep. So all the overhead lights should be down. You there's much maybe calm music you can play.
(1:05:22) Not too much conversation. No arguments. No no no [snorts] fighting with the kids fighting with your spouse. All those hyper sympathetic overdrive should not happen few hours before uh bedtime. So bedtime again is a process. >> It's a process. Eating is a process. Bedtime is a process. Movement is a process.
(1:05:40) If you do this process, >> health is hard work which is why [laughter] nobody does it right. >> That's why medical system is flourishing. >> That is why the medical system is flourishing. And that is why it's so easy to give a pill for every ill. >> Pill for every ill. >> Yes. You just and that that you know what do they call you name a disease you blame it for all your problems and then you try to tame it.
(1:06:05) So name it blame it tame it game is what we play in medicine >> whereas in health it's literally a strategy just like wealth how are you investing where do you want to invest we put so much effort into that put that effort into your health because then someday you'll have so much money but no health to enjoy it. But there'll be always there will be so much health that you have always you have time to enjoy it.
(1:06:29) >> Exactly. Like I'm seeing 50 year olds using wheelchair in the airport because they have knee pain and back pain. >> No, that is they're misusing it. >> You think it's misusing? [laughter] I mean that's a small percentage but no some of them are truly >> you can see that they are not well. Yeah I know. No I mean that's true.
(1:06:46) The Indian community is well known for >> as soon as they walk out our India there are 10 people. I mean [laughter] >> I know they I mean they say it's you pass through olive customs everything is faster. >> That is true to >> but but but the younger the age of disease on is scary. >> Oh my god.
(1:07:04) That is the part I think that has to frighten all of us. See the problem is the process of dying is now 25 30 years. We're not dying one day. >> We're we're dying from the age of 30 all the way up to age of 70. And each time like different organs are getting affected and you're accumulating these medications and eventually when death comes it's such a prolonged phase how you should be is like can we not get to those marginal years >> where you're 25 years you're sick >> before you die >> and that should be we should talk more about it we should have that vision I
(1:07:41) think most people don't even care honestly health is not a priority for a good majority of people. >> Can I ask you a very controversial question? How young are you? [laughter] >> I I'll be 59 this year. >> You're 59? >> Yes. >> Wow. You don't look like you're 59. >> Oh, thank you. >> When did all I mean, you said you've been doing this for the last 10 years or so? >> If you were 30year-old, what would you tell yourself? >> Oh my [snorts] god.
(1:08:09) I would have I wouldn't have had the Friday night pizza and taken my kids to McDonald's or taken them to Taco Bell. I used to love the McDonald's meal, right? You get the little happy meal with the little toys which you throw the minute you come home. >> But I'm just saying I think really the one thing that I tell my 30 year olds now when I see them, I tell them we're building your body for your vibrant 80year-old self.
(1:08:37) >> You should not have any symptoms during pmenopause. >> Let's work towards that because permenopause is not a disease. We're making it a disease today. M >> right. I want you to be so strong that even at 80, you can still go and see the world if at that time you have the money and the time. >> Wow. >> So I really think that's why you should start building your health in your 30s.
(1:09:02) If you miss that window in your 40s, if you miss that window in your 50s. If you miss that window in your 60s. >> If you miss the 70s window, I it's a little harder. I find you know whenever I see on my schedule a new patient who's 70 I know the children are bringing them >> I know it's not going to be successful >> unless they come in themselves they say I want to get healthy that's very rare >> so the earlier the better >> the earlier the better >> wow thank you thank you so much you've been just such a wonderful thing um I'm
(1:09:34) sure when you come back we will have to have another detailed podcast again I think more than uh medical doctor. You I think you are a motivator. [laughter] I mean you are a medical doctor as well but in addition to that I think that is what is missing >> in the current medical practice and I wish you nothing but the best in your success.
(1:09:55) >> I I really enjoyed this. I really appreciate you. First of all I was very impressed. I told you we met >> just by chance at a conference and you said oh would you come on my podcast and I'm like okay that's fine. I'm coming. And you remembered >> yes >> when I would come. That was very impressive. So thank you. Thank you.
(1:10:12) Thank you, ma'am. Thank you so much for your time. >> Thank you.