Indian Lifestyle Problems: Belly Fat, Weight Gain & Heart Health | Karan Sarin | FO465 Raj Shamani

India is called the Diabetes Capital today. There are 101 million diagnosed diabetics. There are 136 million diagnosed pre-diabetics. Diabetes is a serious disease. In India alone, as many as 69 million people are living with Type 3 diabetes. Then 12% of the adult population in Indian cities have diabetes. Then, cardiovascular diseases cause 27% of deaths in India. And there is a study that says by 2050, there will be 450 million obese people in India. If nothing changes, one in three Indians has a fatty liver. 80% of those who work in IT have fatty liver. Our guest today is Karan Saran, author of the book "Sick Nation," a researcher, and a certified metabolic health coach. Someone who is very thin and looks healthy, or thinks they are healthy, is not healthy. Just because you are thin doesn't mean you are fit. BMI for Indians doesn't tell you anything about your health. But how do I know that I have insulin resistance? The very first clinical marker is called skin tags. Usually, people get small skin bumps around their neck. They will be on the neck, in the groin, or wherever the skin rubs, small tags start to form. Or the skin will start to darken a bit. Skin patches are also usually seen near the neck. These two are clear indications that you have resistance. Recently, Singapore banned spices. Two Indian spice brands are under scrutiny in Hong Kong and Singapore. Singapore and Hong Kong cracked down on the sale of spice mixes that have been manufactured by popular Indian brands, after allegedly finding cancer-causing pesticides in several samples. Because Singapore said they are cancerous things, so now there's a problem with spices too. So nothing is right, is it? Flour isn't right, spices aren't right, fruits aren't right, so what is right? It's not like that. I tested 10 different types of flour. Two flours performed much better. And they were ancient grains, barley and millet. They gave me a much lower, much gentler blood sugar spike compared to wheat. When I eat sugar, where does it go first in the blood? What happens? The amount of sugar that your body needs for survival is zero grams. Are your ancestors not eating the same grains that you are eating? You are an advocate of animal-based diets. There have been enough researches that say vegetarian diets are better for you than an animal-based diet. You are the first one who has come who is like, animal-based diet should also be taken. It's not like that. Before moving forward, please subscribe to this channel so that we can continue to make more insightful and better podcasts for you. And the audio experience of this entire show is available on Spotify, where you can follow us. Enjoy the show. You mentioned a lot about the invisible crisis, right? What is the invisible crisis? Or before talking about the invisible crisis, let me tell you what the problem is. Okay, so I think we all know that India is called the Diabetes Capital today. Right? There are 101 million diagnosed diabetics. There are 136 million diagnosed pre-diabetics. Okay? Then, cardiovascular diseases cause 27% of deaths in India. 27% of all deaths. Okay? Cardiovascular disease is only getting younger. The average age for a heart attack in India today is 53. Internationally, the average age of a heart attack is 63. So we Indians tend to get heart attacks a decade earlier. Okay? If we talk about obesity, the prevalence of obesity today is 40%. And there is a study that says by 2050, there will be 450 million obese people in India. If nothing changes, 450 million. Fatty liver. One in three Indians has a fatty liver. Right? There was a report recently. It was even crazier that people who work in IT, 80% of them have fatty liver. Then, if you talk about neurodegenerative diseases like Alzheimer's and dementia, that is on the rise. 20% of our population will be above 60 years old in 2050. Okay? We are not just facing a diabetes crisis, we are going to face a dementia crisis very soon. And lastly, today, reproductive or fertility-related disorders are on the rise in India. Okay? Fertility-related disorders. I think there are some numbers, like 25.1 million couples or so are struggling with fertility issues. The most common in men is erectile dysfunction. The most common in women is PCOS. And they are all getting younger and younger day by day. Erectile dysfunction used to happen in the 30s and 40s. Sorry, in the 40s and 50s. Today, men in their 30s are having the problem of erectile dysfunction. PCOS is also getting younger. It used to happen later, but now PCOS is commonly coming forward even in teenage girls. I have a teenage daughter, so personally, I get scared. All these things I told you are metabolic dysfunction. This cluster of problems is called metabolic dysfunction. These are not seven or six different diseases. They are connected. It's a cluster of problems. If you have one, there is a very strong chance you will develop another, maybe at a different point in your life. Erectile dysfunction. There was a study recently. I think it came out this year, in 2025 or 2024. The title of that study was "Erectile Dysfunction is the First Symptom of Insulin Resistance." And if you have erectile dysfunction in your 30s, then I am forgetting the exact figures, but your risk of a cardiovascular event in your 40s-50s is three to four times higher. If you have diabetes, the risk of a cardiovascular event is three to four times higher. So these are a cluster of problems. They all manifest differently in different people. But the chances of having one disease and having another such disease later in life are pretty high. So this is called metabolic dysfunction. Okay, okay. So this is a metabolic epidemic. We are facing an epidemic, and we are not talking about it as much as we should. What is metabolic dysfunction? First of all, actually, before that, let me say something that hurts me the most. This is not only manageable, it is actually reversible as well. Okay. What happens? Then we will talk about reversal. Metabolic dysfunction. A few years ago, a few years ago, it used to be said that insulin syndrome and insulin dysfunction or metabolic syndrome were called insulin syndrome, insulin resistance syndrome. Before we talk about insulin resistance, which, by the way, is the common denominator among all of these diseases. All the metabolic diseases we talked about, their common denominator. What would you call the common denominator in Hindi? You know, it's a common denominator of all these disorders. Insulin. Insulin resistance. There are studies. I have also published in the book. As per the studies, one in three adults in India has insulin resistance. Okay. People don't even know. Exactly. 90% of the people who have it, they don't know that they have it. So 90% of people who have insulin resistance don't know they have insulin resistance. What are the reasons for that? We can discuss that now. But first, you asked what it is. Look, before talking about insulin resistance, we need to talk about insulin. Because many people have the misconception that insulin is a medicine or medication that diabetic people take, which is true. But insulin is a hormone that your pancreas, that's an organ located behind your stomach, produces. So it's a hormone that is produced by the pancreas. Okay, why does it produce this? I'll tell you that too. We always have glucose running in our bloodstream. Our body works very hard to maintain a very narrow range of blood sugar. Okay? The reason behind this is that if our blood sugar gets too high, it is toxic in our body. High blood sugar is toxic. If blood sugar gets too low, it is also very harmful. Actually, the glucose supply to our brain can stop. You can get seizures, or you can even go into a coma. So our body tries very hard to maintain this blood sugar in a narrow range. Okay? Now, how does blood sugar increase? Whenever we eat carbohydrates, when they are digested in our body, they convert into glucose. Okay? So your body's glucose level will increase. Now, I told you that maintaining glucose in a narrow range is very important. Okay? So our pancreas detects that the glucose level is increasing. So it releases insulin to bring the glucose levels down. Okay? How does insulin do this? Insulin doesn't actually take away the excess glucose running in the bloodstream, but it disposes of it in our various tissues. For example, the two most common disposal sites are: one is your muscle tissue, skeletal muscle, and the second is your fat cells. So what is the function of insulin? You can think of insulin as a bouncer. Your pancreas sent a bouncer to the muscle tissue. The muscle tissue bouncer knocked. He said there is excess blood sugar. Consume it. And the same logic goes for your fat cells too. Okay? So insulin facilitates the uptake of your blood sugar in these tissues. Okay? Now, what happens is that when these tissues, our muscle tissues, consume glucose, they either convert it into energy immediately so you can use it, or if you don't need immediate energy, they will store it for future use. That's the logic. That is how insulin brings our blood sugar down. Okay? After bringing the blood sugar down, the natural process is that insulin will also decrease in your body. That bouncer did its job, it will decrease. This is the natural physiological process. Okay? Unfortunately. So this is the function of insulin. Are we clear up to here? So unfortunately, today we find ourselves in an environment where this insulin is not coming down. Insulin constantly remains high in our body. It remains high. Let me explain this with an example, it will be easier. Most people wake up in the morning, have breakfast. What is breakfast in most homes? Poha, idli, dosa. In the North, paratha, roti, poori aloo. Okay? In modern homes, cornflakes, cereals. Right? All these common breakfasts, top seven, I think. Bread, bread, sandwich. Bread, vada, pav. Perfect. Perfect. These are all majorly carbohydrates. Okay? Almost 70% of these, of all the items that we have just talked about, are carbohydrates. So now you woke up in the morning, you said, "Today I will have a light, healthy breakfast." I will eat poha. So you ate poha. Now, when it digests in your body, it will convert into glucose. Right? Now your blood glucose level has gone up. The pancreas detected that blood glucose is increasing, so it released insulin. So our insulin came to take care of the glucose. In a normal person, blood glucose comes down in two hours. Okay? Healthy people. But insulin stays a little longer. Because insulin wants to make sure that no excess glucose remains. So you can roughly estimate that for two to three hours, your insulin is elevated to take care of the glucose you ate. Now, we come to mid-morning. It's 11-12 o'clock. Okay. We've reached the office. We need tea. What's in tea? Usually with sugar, or we think we'll put jaggery in it. If we're drinking tea, we also need a cookie or a rusk. All these are carbohydrates, simple sugar. So you have increased glucose in your body again. The insulin that hadn't come down from the previous meal was high, but now you've added more glucose load. So it won't just stay high, your pancreas will produce more insulin to take care of the extra glucose you just added. Right? So insulin is high again. This process takes two to three hours. Now we come to lunch. Most people eat what for lunch? Roti, sabzi, dal, rice, rajma, rice, kadhi, rice. Right? Or roti, sabzi. Roti, sabzi. Carbohydrates. So you've increased glucose again. So from morning to afternoon, insulin is still running high in your body. Right? Then it's evening, we need some snack. What do most people eat as a snack? Someone [laughter]. What is it? It's carb on carb. Potato on carb, or flour on potato, or flour on flour. Whatever. Right? So you've spiked your blood sugar again. So in the evening too, insulin hasn't come down, rather it's increasing. Eventually, your body thinks, "Well, night is coming. Maybe the person will give me a break now." We go home, we have dinner. What do we eat for dinner? There will be roti. Maybe we'll get some protein, we'll eat paneer, we'll eat dal. But carbohydrates will be a major component of our meal. So your insulin was high since morning. You spiked it again by adding glucose. Now you are going to sleep, and you are going with elevated insulin levels. So your insulin is chronically elevated for the entire day. This is called hyperinsulinemia. But unfortunately, it doesn't end there. This is repeated day in and day out. We do it the next day, the day after. So your insulin levels in the body are chronically elevated. And that causes insulin resistance. That's the number one cause of insulin resistance. There was a study recently, right? Out of tested Indians, 30.5% of Indians show. One in three Indians. So 30.5 is almost one in three. In insulin, not hyper. What's the pity? That 90% of people who have it don't know. Do you know the reason behind that? There are three reasons behind it. The very first reason is that insulin resistance is largely asymptomatic. Okay? It doesn't have obvious symptoms. It's not that there are no symptoms at all. There are some, but those symptoms are easily mistaken for something else, like lethargy after meals, or you know, you feel lethargic, or cravings are sometimes very high, sugar cravings. They are actually early symptoms of insulin resistance. But the problem is that they can also happen for other reasons. So people mostly don't pay attention to it. Otherwise, insulin resistance is largely asymptomatic. It has no symptoms. You are just defining me, bro. Like [laughter]. Then I will tell you what you need to do. This is the first reason. The second reason is that its progression is very slow. By the time you see the first symptom, 10 years will have passed. So its progression is anywhere from 10 to 15 years. Maybe I will break down the progression. So its progression is very slow, hence it's not noticed. And the symptoms are asymptomatic. And the third biggest reason is that our medical system is designed to treat diseases, not to prevent diseases. Agreed. They look at wrong markers. We are obsessed with testing fasting blood glucose in our annual checkups. We are obsessed with HbA1c. We think if this is okay, then everything is okay. These are late-stage markers. They will show up high in the end. So we are not catching the right thing. So you are telling me 90% of Indians are sick? 90% of Indians have the disease but don't know it. The research says one in three Indians. Okay. 30% of the population has resistance. Out of them, 90% don't know they have resistance. So you are telling me that 30% of people, almost 30% of people, have this problem in India. Every third person has it. And out of every third person who has it, perhaps they don't even know they are sick. So they think they are healthy. 100%. So how will they know? This is what research says. Again, if you look at credible ICMR-type research, if you ask me my personal point of view, I think this number is much higher than one in three. And I can actually give you a data point for this. There is a study by ICMR itself. In that study, in which they stated that there are 101 million diabetics in India and 136 million pre-diabetics, another data point also emerged: that out of the people who had diabetes, 57% of them didn't even know they had diabetes. So 57% were unaware that they had diabetes. So now, if you correlate this, how many are undiagnosed cases? And where that number would end, it is much higher. So tell me, what if I want to know today if I have insulin resistance or not, how will I know? It's very simple. That's the pity. It's so simple, and we are not doing it. Because in hyperinsulinemia, what I know is that blood sugar shows normal. So, before talking about how to find out, let's talk about its progression. After that, I will answer your question about how to find out. Okay. So far, the example I gave you was of a person, a healthy person. We discussed their eating pattern. And by the way, this eating pattern is not abnormal. I think it would be for most people that we discussed. Yes, this is normal in India. Exactly. Right. So let's continue with this. So what is the most insidious nature of insulin resistance? That your body has a compensatory mechanism to take care of this problem that is happening. Your insulin is constantly high. At a certain point in time, your tissues become resistant because they have only so much capacity. No, they will also say, "Man, you're not stopping. Stop sometime." Even your fat cells will say, "How much energy should I store?" A fat cell is one of the only cells in our body that can grow 100 times its size. It's like a water balloon. But boss, someday that balloon will burst. And fat cells don't want to burst. Why? Because if it bursts, it will release inflammation in your body, which will cause further damage. So, to protect itself from the effect of insulin, it makes itself resistant. Muscle tissue does the same. So in this way, your tissues make themselves resistant. So basically, that bouncer is coming, saying, "Open the door, man, there's extra glucose running," and your tissues say, "Man, I can't take that, boss. That's it. Enough." Okay? To counter this, our pancreas has a compensatory mechanism. What do they do? Our pancreas thinks, "Man, blood glucose is not coming down. Why are these fat cells not taking it? They are not listening." So what should we do? Let's send two more bouncers. Okay, still not listening? Let's send four more bouncers. So basically, our pancreas starts to produce even more insulin to take care of it. Because high glucose is toxic in your body, right? So the body will do something about it. So its compensatory mechanism is that our pancreas starts to produce more insulin. And by the way, this works. This works for not a short time. This works for 5 to 10 years. So for five to 10 years, your pancreas is producing more and more insulin to take care of the excess glucose. Okay. Now your insulin levels are high in your body. But why? That high insulin level is managing the glucose. So if you go to get tested, your fasting glucose will be normal. Your HbA1c will be normal. But your insulin will be high in the body. Okay? This is a compensatory mechanism. This goes on for up to 10 years. Maybe everyone's timeline will be personal, but so figure it. Please figure it. Even speaking. Meaning, for 10 years, your pancreas will manage this. But what will happen in the end? Your pancreas will also give up. "Man, I'm so abused." So your beta cells will start to dysfunction. Okay? Your beta cells will actually die. And once they die, then you can't create more new beta cells. So slowly, beta cell dysfunction will happen. Now, even the extra insulin it was producing is not enough to keep your glucose in the narrow range, and then your glucose will slowly, slowly start to increase. This process takes anywhere from five to 10 years. In the 11th year, you go for your annual checkup. Your doctor orders the same tests: fasting glucose, HbA1c. But now your pancreatic beta cells are quite exhausted. Now your glucose is struggling a bit. Now in your tests, your fasting glucose comes slightly above 100 milligrams per deciliter. Your doctor will say, "You have pre-diabetes." Now you have pre-diabetes. He didn't tell you that the undiagnosed insulin resistance of the last 10 years is how you were led here. But now you are pre-diabetic. At that time too, what advice is given to most people? Eat less, move more. And that advice has worked for no one ever. You go back, you carry on with life. Because you don't have proper knowledge. So I don't blame you. I don't blame you. You don't even know how to manage it. You carry on with your life. Okay, add a walk or two extra. Right? Five more years pass. But that abuse is still going on. Now your beta cell dysfunction has increased. Now is when your blood sugar levels will be high in your body. You go for your annual checkup again after 5 years. Your fasting blood sugar will now come above 125 milligrams per deciliter. And there, your doctor will declare you diabetic. And at that point in time, he will tell you, "Man, you're diabetic, take medicine." So he will give you glucose-lowering medicine. And these medicines are really good at masking the symptoms. So that medicine will reduce your glucose, but the underlying problem was never addressed. Your body is still very high in insulin. There is beta cell dysfunction, that has not been addressed by anyone yet. So what is the medicine doing? It's just masking the symptom, glucose. The underlying dysfunction is still continuing. And insulin is known to lower blood sugar. But that's just one function of insulin. Insulin impacts every cell in your body. How every cell in your body processes energy, insulin decides that. Insulin has a very important role in memory formation in your brain. How your liver handles fat, the liver decides that. Will your reproductive hormones be balanced or not? Insulin decides that. Insulin touches upon every single cell in your body. And that is why that one dysfunction, which is not addressed, it starts causing other disorders down the line. But how do I know that I have insulin resistance? Yes, let's talk about this because it's very simple. Insulin resistance. Insulin resistance. Insulin resistance is bad. You want to be insulin sensitive. Okay? Just to make sure the terms are clear. Yes. It's so simple to detect that I feel pity that why aren't we doing it? Tell me. You don't even need a blood test. But I would definitely suggest talking about blood tests. And I will suggest getting blood tests. Get them regularly. In fact, be proactive about your health. But actually, you don't even need a blood test. So there are certain clinical markers that you can look at and tell. I can look at you and tell whether you are insulin resistant or not. Tell me. Once you have this knowledge, you will also be able to do it. I don't think, by the way, that you are. [laughter] Okay. So there are clinical. Thank you. You will be able to do it after this conversation. The audience listening to this conversation, after hearing this, they can not just judge themselves. They can also tell by looking at others. It's so simple. Tell me. The very first clinical marker, I'm sure you've seen it. It's called skin tags. What? Small skin tags. Okay. Usually, people get small skin bumps around their neck. Skin tags. Have you seen skin bumps ever? Or they will be on the neck, in the groin, or wherever the skin rubs, small tags start to form. Either that will be it. Or the skin will start to darken a bit. Skin patches. They are also usually seen near the neck. Yes, it becomes black, black. Like a velvety, you know, velvet patch, black. And people think it's dirty, but it won't wash off. It will stay there. That is a skin patch. These two are the clearest indications that you have insulin resistance. Why? Because insulin is a growth hormone. It's an anabolic hormone. It promotes growth. It's promoting excessive growth in your skin cells, which leads to skin tags and skin patches. Clear sign of insulin resistance. Simple. Anyone can figure it out. You can recognize it by looking. You can recognize it. Anyone can recognize it. Right? Second clinical marker. Your waist size. Anyone can recognize your waist size by looking. You know, you can measure it yourself. Right? You can also tell others by looking. Waist size has a very strong correlation with insulin resistance. Simply because when insulin-resistant people store fat, they tend to store fat in the visceral area. Visceral is here. That pot belly that was considered a sign of prosperity among Punjabis, that is actually a sign of insulin resistance. That means you have stored fat in your belly, in the deep abdominal cavity, around your organs, or ectopic fat in your organs, like fatty liver. That will make your waist circumference go up, and that has a clear sign of insulin resistance. There are guidelines for this too. Typically for men, it goes, I think it goes like 90 centimeters or less, or for women, 80 centimeters or less. But a better measure than that is, because it adjusts for your body, that your waist should be half of your height. So if your height is 160 centimeters, then your waist size should be 80 centimeters or less. If it's more than that, it means you have visceral fat. If you have visceral fat, then there is a pretty good chance that you are insulin resistant. Okay? So that's the third marker. Fourth marker. If you have erectile dysfunction in men and PCOS in women, there is a very strong chance that you are insulin resistant. 70% of PCOS cases are driven because of insulin resistance, as per research. And about erectile dysfunction, I told you earlier. I told you about that study whose title itself was "Erectile Dysfunction is the First Symptom of Insulin Resistance." So if you have this, then it is a very strong chance. So just to wrap up clinical markers: your skin, excessive skin growth in the form of skin tags, skin patches, your waist circumference, high blood pressure, ED, and PCOS. It's simple, isn't it? Everyone can figure it out, right? This knowledge? What about? You are saying something. I was going to go to blood markers. Go ahead. So if you have any doubt about these clinical markers, you know, you fall into any of these, or even if you don't, I would highly recommend that you get the following blood tests done. I don't understand. It actually bothers me that why are these blood tests not included in our regular checkups? Meaning, we are checking for late-stage markers. Fasting glucose, HbA1c, which will show up after 15 years. The marker that will show up in the first 15 years, we are not even testing that. And that is fasting insulin. Fasting insulin is a simple blood test. Almost every lab will do it. You can't do it at home because it's measuring a hormone, so it's not as simple as the blood sugar one you can do at home. So you will have to go to the lab. But I think every lab in India would do it. And it's a cheap test, under 500 bucks. Less than ₹500. I'm pretty sure. In many places, it's even cheaper. Fasting insulin will tell you what your insulin levels are in your body. What more direct marker could you get? If your fasting insulin levels are elevated, that is a clear sign of insulin resistance. But I want to give a warning along with this. And this makes me more angry. When you order this blood test, your result will come. It will have a reference range written on it. In that reference range, it will say up to 25 is normal. I can guarantee you, if your fasting insulin is 25, you are deeply insulin resistant. Deeply. Do not mistake that number for you being fine. But your lab will call 25 normal. Why? The reference range is never an optimal range. It's at the population level. It's the average at the population level. So if we as a population are becoming unhealthy, metabolically unfit, then that average will increase. If the population is sick, then our average is also sick. That is how reference ranges are given in every lab report. I'm not just talking about fasting, but every lab report's references are the average of the population. So if your report says 25, which they call normal, then you are insulin resistant. You want that number to be five or below five. Or below that. You want fasting insulin levels to be five to seven is good. Seven to 10 is early resistance. 10 and above is insulin resistance. Crazy. But then there is this phenomenon which is called the thin fat phenomenon, right? That outwardly thin, fat inside. So what is that? And why is somebody who is very thin and looks healthy, or thinks they are healthy, not healthy? Like you said, thin outside, fat inside. Scientifically speaking, it's also called by many other terms. A lot of research has been done on this. You might have heard of the thrifty genome type, Asian Indian paradox, Indian thin fat phenotype. Dr. Chittaranjan Yajnik in Pune, he is among the top 2% researchers in the world. He has been a pioneer of the Indian thin fat phenotype. So all of these things, in essence, say the same thing. The short headline is that just because you are thin, that doesn't mean you are fit. So in homes, moms think that if their child is thin, then they are healthy, fit, so they...

And should be fed. And should be made fatter. Because technically that person is healthy. Yes. Uh, which is, which is scientifically and research will tell you that's not true. The reason behind it is because actually let me tell you something more interesting first, then I will come to this. Do you know BMI, which tells you about your weight, you know, about weight, is the worst proxy for your health? Yes, BMI, and everyone tests BMI. BMI for Indians doesn't tell you anything about your health. Why am I hearing this for the first time? Yes, there is research I have cited in the book. If you look at that research, then what that research found is that Indians tend to develop metabolic disorders. We Indians develop metabolic disorders at a lower BMI compared to Westerners. What is the typical BMI range? 25 is for overweight, and 30 is for obese. I don't know if you know this. For India, this BMI range has already been revised. In India, now it is 23 for overweight and 27.5 for obese. Really? Simply because the research will tell you that we develop metabolic dysfunction at a lower weight and lower BMI. Why? For Indians, metabolic dysfunction starts showing around BMI of 23. If it's a Westerner, a Caucasian European, they have a much bigger threshold. They develop metabolic dysfunction at a much higher BMI compared to us. So first of all, understand this that BMI and weight are terrible markers. Simply because it is all about our fat cells. BMI tells us weight, but BMI doesn't tell us about your fat, where that fat is stored. BMI doesn't tell us how your metabolic health is. BMI doesn't tell us what the characteristics of your fat cells are. I will tell you about all of these three things. Our fat cells, our fat, it matters two things matter a lot when it comes to storing fat. First is where you are storing it, and secondly, how you are storing it. There are two or three places to store fat in the body. One is sub, one is called subcutaneous fat, which is under the skin. Okay, which by the way is a healthy way of storing fat. You can convert it into energy, subcutaneous fat, and it is a metabolically healthy way to store fat. Second, when we store fat, we store it in our visceral area. Your visceral area is in your deep abdominal cavity, around your organs, or even in the organs, we store fat, which is called ectopic fat. Visceral fat and ectopic fat are the worst places to store fat. You will be metabolically unhealthy. They will cause, they will directly influence your insulin resistance and cause metabolic dysfunction. We Indians are predisposed to store fat in our visceral area. Okay? Why are we predisposed? I am happy to talk about that. It's a very interesting history. But first of all, let's understand that we Indians, compared to Caucasians or Europeans, store fat mostly in the visceral area. Whereas the Western population tends to store it subcutaneously, which is the healthy way. Why does this happen to us? It's a long story. Tell me the long story. This is part of the evolution. Okay. Okay. I don't know if you know this. During the British Raj, during the colonial times, they ruled us for 190 years. Okay? From 1754 to 1947. Right? Something around that time frame. In those 190 years, there were 31 famines in India. Famine means starvation. Starvation, which is an average of one famine every six years. Before that, famines used to occur once in 50 years, once in 100 years. So during the colonial rule, we had accelerated famines. And by the way, these did not happen due to any natural calamity. They happened due to policies. These famines occurred due to British policies. They prioritized farmers, they forced them to produce cash crops. Cash crops are, for example, opium, sugar, cotton. They fetch more money. So they forced our farmers to produce cash crops over staples. Instead of wheat and rice, produce a cash crop. So the production of your staples decreased. After that, they oriented the majority of the economy towards exports. They also built the railway network in such a way that exports could happen easily. So they exported the majority of what was grown, leaving less for local consumption. Okay? Third, what they did was, before they came, the kings and emperors were very wise. And they always maintained a reserve so that if a famine occurred, they could feed their subjects from their reserves. And we would pass through that time. If a natural calamity occurred. They systematically broke that storage system. This is entirely because of the British policies that these famines happened. 31 famines. Now, our body, for 190 years, you know, with a famine occurring every six years, it had to evolve because of the environment to survive in that scarcity, to survive in that starvation. One of the evolutionary things that happened is that our DNA doesn't change easily, but epigenetics change. So our epigenetics evolved to hold fat. We Indians have become really good at storing fat. And most of that fat was stored in our visceral area so that it could be easily converted into energy when the next famine came. And this evolution happened generation after generation after generation. These epigenetics are passed on. These epigenetics are passed on for a long time. There is a study that I have mentioned in the book. There was a famine in China in 1954. A researcher studied its impact for three generations. For the first generation, he looked at mothers who were pregnant during that famine. They were expecting babies. He called this the F0 generation. Hmm. And obviously, this generation of mothers had to adapt to survive because you don't just have to provide energy for yourself, but also for the baby. So their epigenetics evolved very rapidly to care for the baby they were expecting. Yes. After that, this researcher studied the next generation, the children who were born, whom he called the F1 generation. These children never directly experienced the famine themselves. But they were in their mother's womb during the famine. What he found was that that generation had a 75% higher risk of diabetes or metabolic dysfunction. 75%. And that generation never experienced famine. It didn't stop there. He went to their children. So basically, the grandchildren of the F0 generation. These were born much later, and they never even came close to famine, never saw it, never understood it. Their chances of diabetes were two times higher than the average. So you have to understand that epigenetics change. They evolve for survival and are passed on from generation to generation. Our, we have gone through an extreme famine phase. Our body is a survivor body. Okay? The problem is, we have taken those epigenetics and those survivor genes, but now we are not living in famine. Now we are living in abundance. So those genes have turned against us now. Earlier, there was no meal, no energy. Today, the average person eats three to four, three to six times a day. We have become app users from hunter-gatherers. You order on your phone, food arrives in 10 minutes. So today, there is no shortage of energy. But our genes are from scarcity, but we are living in abundance. That's the difference. So that is why we tend to store fat in the visceral area, just to come back to that. Yes. Second thing, where we store fat matters a lot, and the second thing I told you, the characteristic of the fat cell matters a lot. There are only two ways to gain fat. Either you increase the number of fat cells in your body, which is called hyperplasia, which by the way is a healthy way of storing fat. Okay, hyper, hyperplasia. Okay, that means your fat cell is not growing, but the number of fat cells is increasing, basically. The mass of the fat cell, not the mass, right? So that's one way of gaining fat. The second way of gaining fat is that the size of your fat cell is increasing, which is called hypertrophy. Okay. We Indians, when we gain fat, we tend to grow the size of the fat cell, which is an extremely unhealthy way of gaining fat. The size of our fat cells increases. The number of cells doesn't multiply. And this is how we design. This is how we are designed. There is research. I have it in the book. Where I have actually used images. In that research, they compared the fat cells of Caucasians and South Asians. And they found that Caucasians tend to have smaller fat cells but more fat cells. And South Asians tend to have fewer fat cells but bigger fat cells. Why is this a problem? I told you earlier, a fat cell doesn't want to become too big because if it becomes too big, it will eventually burst, so it makes itself insulin resistant. So that is why we are predisposed to insulin resistance. That is what is happening. So we tend to grow the size of the fat cell. But then, so sorry, just to finish up. That's why BMI is a terrible marker because BMI only tells you what your weight is. BMI does not tell you where you are storing fat. BMI does not tell you what the characteristic of your fat cell is. And obviously, that does not tell you what your metabolic health is. But then, what's the better alternative if we don't consider BMI as a marker of whether I am healthy or unhealthy, fat or thin, whether I am internally fat or not? Is it a visceral fat marker? Is that what you are suggesting? There are five things. This is called the harmonized criteria. Science, according to science, there are five things. Three of them, three or four of them, they are related to your blood, blood tests. So if your fasting blood sugar is above 100. If your triglycerides are above 150. If your HDL is below 50 or 40-50. If your blood pressure is above 130/80. Fourth and fifth is your waist circumference, which I told you earlier. 90 cm for men, 80 cm for women. If you have three of these five things, then you have a metabolic syndrome. That is the harmonized criteria to identify metabolic syndrome. Let's make it easier for people. Okay. Yes, let's talk about the cost. Meaning, why does insulin resistance happen? For what reason do people get it? Sugar is a big thing, yes? Right. Because you said carbs, carbs become sugar. Simple sugar, direct sugar. Everyone in India eats a lot of sugar. Let's talk about sugar a lot and let's break it down simply based on your book and based on your research that everyone knows now, it's established around the world, around countries, through this podcast, everywhere multiple times. Excessive sugar is absolutely poisonous. Right? You have said sugar is the new tobacco. Tobacco is the new tobacco. Many people around the world, many doctors have said it, and I have heard it myself in conferences where really, really big doctors come up and say that sugar is more dangerous than smoking if you are taking it on an everyday basis and you are thinking that, oh, it's nothing, right? So sugar is the devil. Everyone has accepted it. Few people also say that moderate sugar is bad. Forget excessive sugar. So let's break it down. Let's make people understand what actually happens from sugar. When I eat sugar, I will ask you simple, simple things. When I eat sugar, it first goes into the blood. Where does it go? Like, what does, what happens? The amount of sugar that your body needs for survival is 0 grams. Your body doesn't need sugar. Why does it need it? You tell me. You only said that less sugar, meaning if glucose and sugar decrease in the body, then that can cause brain freeze, brain stroke, multiple other things. But your liver is fully capable of producing glucose to supply to your brain through gluconeogenesis. Your body needs roughly, I think the brain needs about 120 grams of sugar throughout the day to keep doing its function. Your body is capable of producing more glucose through your liver. You don't need external sugar. First thing, understand this. You need 0 grams of sugar. 0 grams. There is no nutritional value in sugar. You need 0 grams of sugar. Okay. But actually, you know what? You said something very good. Nowadays, there is so much awareness that people have reduced sugar. People generally know that sugar should not be consumed. It's not good. True. But still, metabolic disorders are increasing. Do you know why? Why? Because there is a lot of invisible sugar in our diet. Explain invisible sugar in our diet. You are drinking black coffee. You won't add four spoons of sugar in it. Zero. You won't take it. Right? You will eat two rotis? Yes, you will eat them, right? You eat three or four. You eat three or four. What's the difference between the two? When it is being digested, when you consume sugar, it converts into glucose in your body. Your pancreas has to release insulin to take care of that glucose. The roti you are eating, when it is digested in your body, it will also convert into glucose. What are you saying? That eating sugar directly is almost the same as eating sugar. Sugar is a carbohydrate. Whichever flour you pick. If I eat flour, then flour and sugar are the same. I don't believe that. I agree with the fact that okay, how many carbohydrates are in this flour? If you take whole wheat flour, amaranth, amway, whatever you take. If you look at its macronutrient composition, it is roughly 70% carbohydrates. Okay. Sugar is also a form of carbohydrate. Sugar is actually in the family of carbohydrates. Carbohydrate is a bigger family group. Sugar is part of it. Fiber is part of it. You know, all of these things are part of it. So when you eat roti, when it goes into your body, it is basically a carbohydrate. All grains, by the way, are. And it is causing your blood sugar levels to go up. Your pancreas still has to release to take care of the glucose levels. Your body is not discriminating between sugar and roti. Why are you? Why are you? You are eating rice, it has 70+ carbohydrates. When it goes into your body and gets digested, it will turn into glucose. There is no other way around it. So your pancreas will still have to release insulin to take care of the glucose. Your body is not treating rice differently compared to sugar. So why are you treating it differently? So should I stop eating? No, but you can control it. About two months ago, three months ago, an ICMR study came out in which it was stated, in which they explained that 70% of our calories are coming from carbohydrates. And just for your knowledge, the macronutrients are only three macronutrients: carbohydrates, fats, and protein. According to nutritional science, carbohydrates are the only food group that is considered non-essential. Your body is fully capable of producing the glucose that you need without you eating it. You don't need it, nutritionally speaking. You don't need carbohydrates. I am not saying you should stop. But I am just telling you about the science. The other two, protein and fats. Your body cannot make them itself. There are nine essential amino acids that your body cannot make itself. So you have to supplement that with food. There are fats, omega-3, omega-6, that your body cannot make itself. They are essential. They are considered. So you have to have that through food. So protein and fats are essential food groups. We are not eating them, but we are filling 70% of our plate with a non-essential food group. There is only one thing that triggers your fat cells to grow, and that is insulin. We only talk about calories. Calories are an incomplete equation. We talk about calorie in, calorie out. Of course, calories matter. But to store those calories, they need someone, they need a trigger, and that trigger is insulin. If your insulin is low, you are in a fat-burning state. You are not in a fat storage mode. I can give you absolute proof of this. After this, you will not actually ask me any more questions. Do you know Type 1 diabetes? Type 1 diabetics, they have an autoimmune condition where their insulin is not produced. Yes. So they are always dependent on external insulin. Right? There is an eating disorder in Type 1 diabetes called diabulimia. What is this? Before I tell you what it is, I must say it is extremely dangerous. Don't try this at home. Okay? If a Type 1 diabetic, if they are conscious about their body and, you know, they want to stay slim. What they do is they stop taking exogenous insulin. Exogenous insulin means insulin they depend on from outside. Right? They stop taking it. A Type 1 diabetic can eat even 10,000 calories a day, and if they are not taking insulin, there is no chance that they can get fat. It is called a condition called diabulimia. This should tell you that insulin is the trigger for fat storage in your body. It is undeniable. Yes, calories matter. But if there are no calories, how will you store energy? But who will decide whether that calorie is to be stored or burned? Insulin will decide. Now you will ask, where are those calories coming from? Yes, all this that we are eating, where are the calories coming from? Right? Now, thermodynamics, the group outside will be very angry, saying that this is breaking the law of thermodynamics. When your insulin is low, it will only happen when glucose is low in the body. Your body still needs a fuel source. Now it will break down fats to give you fuel. Your fat. Okay? And your brain cannot directly use fat as fuel. So your liver breaks down your fat and converts it into ketone bodies. And your brain loves ketones. It thrives on ketones. We will talk about ketones. And the ketone bodies are what give the fuel to your body and to your brain to not only function but thrive in that condition. And these ketones have a caloric value of 4 kilocalories per ketone molecule. When you are in nutritional ketosis, you literally, literally pee out and breathe out these ketones. That is where those calories are going. Let's talk about that is why it breaks the law of thermodynamics because that calorie, that energy, your body at low insulin levels is burning fat like anything. You are getting shredded, and because your insulin is low, your body needs fuel. Your body will start breaking down fat, and your liver will convert that fat into ketone bodies to supply to your brain. And that ketone body has a value of four kilocalories each molecule. And you pee out ketones. If you test your urine at that time, you will see high ketones. You are breathing out ketones. You are basically breathing and peeing out fat. Like when you are, when your body gets used to this ketosis and you are on this permanent diet and you are using these fats to actually give your brain more fuel. So the body has become efficient. The brain has become more efficient. But the function of glucose throughout the body starts to go a bit wrong, doesn't it? The body starts to deteriorate in order to just cut down and kill. You know, from today, you go back to the hunter-gatherer time frame. Hmm. If you go back to that time frame, we were in a constant state of nutritional ketosis there. And we were in the state, we were switching between ketones and glucose. If you go to hunter-gatherers and human evolution, if you look, for 1.8 million years, we have been hunter-gatherers. Hmm. Okay? When you are a hunter-gatherer, the first thing is that food will not be available all the time. True. Okay? You have to hunt for food. Okay? So you are always in between feasting and famine. That was our natural state. We were built for that, by the way. Yes. 1.8 million years. Agriculture came only 10,000 years ago. And I think industrialization is even more recent. So for 1.8 million years, we were hunter-gatherers. We were supposed to be in a fasted and fed state. When food is available, your glucose will increase in the body. Right? And insulin will increase. You will go into fat storage because you don't know when you will get the next meal. So your body is storing fat for you to get by the next day until you kill the next animal or find the next plant. So we were designed to be feasting and famine. So it is not a bias. This is your evolution. But now your body is used to permanent eating. Right? So the famine aspect has ended for you. If you try to train your body again to stay in a permanent no-carbs zone, where you are not eating enough carbs, and then immediately when you start carbs again, the impact on the body, if there was any impact of carbs on my body before, the spikes will now be even greater because now my body is not very used to actually. But who is saying that you have to stay in that state permanently? See, the ketogenic diet, what is the ketogenic diet? First, let me explain. So a ketogenic diet is where you consume extremely low carbohydrates. Okay? Carbohydrates are typically less than 50 grams per day. 50 grams or less carbohydrates to get into ketosis. Which is like very minimal. You might eat one apple and you will be done with your 50 grams of carbs. Or roughly, right? Low carbs. It is high in fat. So fat is roughly around, you know, 70% or so, and then roughly 20-25% protein. That's the ketogenic diet. How was the ketogenic diet invented? It happened in the early 1900s. Do you know this? Its invention was by accident because at that time there was no treatment for epilepsy. Hmm. Okay? For epilepsy. Ketogenic diet was actually invented as a treatment for epilepsy. Why? Because in the early 1900s, researchers and scientists figured out that when your brain uses ketones, there is a remarkable improvement in your epilepsy. And that is when the ketogenic diet was officially used medically to treat epilepsy. That is the beginning of the ketogenic diet. It is so powerful. Since then, the ketogenic diet is used as a treatment therapy for diabetes. I explained the issue with diabetes at the beginning. Your insulin is constantly high, chronically high. But blood sugar has also become high now. Because your beta cells are not functioning properly anymore. So if you want to resolve this and permanently reverse it, you will reduce what triggers glucose, and slowly your insulin will also start to decrease. And hopefully, you can move towards the path of recovery. So we are talking about sugar, and we just shifted to things, right? In simple words, sugar is poisonous. Now, when sugar enters the body, what happens? So what happens? Like the moment if I eat sugar, then what? When you, when as soon as sugar starts to digest in your body, it will convert into glucose. Depending on how you are consuming sugar. You know, certain sugars will be a combination of glucose and fructose or whatever it converts into. It converts into glucose. But you said that the body needs sugar, how much sugar does the body need to survive? Zero. Externally, zero. External, like external sugar is needed? Zero. Right? So the moment I eat sugar or carbs, which you said is a great explanation. Invisible sugar. Invisible sugar, right? What do Indians eat in a day? Which is staple food is sugar. Predominantly carbohydrates. You see, this ICMR research says that 70% of our calories, poha is useless, dosa is useless, parathas are useless, roti is useless, rice is useless. Everything is useless. No, I am not saying that. Then there is a macronutrient that is non-essential, which is carbohydrates. There is a macronutrient that is the most insulinogenic, which is carbohydrates. I am not saying all of this is useless. Think about it yourself. If it is non-essential, then what percentage of your diet should it be? Ideally speaking, scientifically speaking. So why such a diet for us? Like there has to be some reason why evolutionarily our diet was formed. Just to wrap up, actually. Because I want to get this right. I am not against carbohydrates. I am absolutely not saying that everyone should do low carbohydrate. All I am saying is, please don't fill 70% of your plate with something that is non-essential and is the most insulinogenic. Got it. I am just saying this. But how did this become a trend is what I am trying to understand? Because if the body doesn't need it, when did this trend start? Yes. When did it start and why did it start? If it is not needed, how did it become 70% of our plate? We will go back to the conversation about evolution we were having. For 1.8 million years, we were hunter-gatherers. At that point in time, we only ate three things: meat, fruits if available on trees, you know, sometimes. And at that time, there was no vegetable agriculture, so there were no grains. Root vegetables. Root vegetables. Okay? So root vegetables, fruits, and meat. This was the diet that we had for 1.8 million years. Hmm. Okay? 10,000 years ago, agriculture happened. Agriculture started. That is when we started growing grains, right? Or vegetables. Yes. And you know, a lot of fruits. And actually, we can speak at length about fruits, but that is when basically grains, or essentially carbohydrates, came into our lives. And they have since then become a bigger part of our lives. In India, I don't know if you know this, around 1970, the Green Revolution happened. Why did the Green Revolution happen? Because after independence, India did not have enough food reserves to feed the growing population. Our population was growing very rapidly. We did not have enough food reserves. We actually used to import grains at that point to feed our population. So we had a severe deficiency of grains at that time. We didn't have enough food to feed people. Hmm. So the Green Revolution started in the 1960s-70s to increase our agricultural production. How did that happen? Basically, the yield of our grains was increased. How does that happen? Through the hybridization of our grains. Before the Green Revolution, if you look at a wheat plant, it used to be really tall. It was tall, prone to wind, would break easily. You know, the production, the yield was very low. There was a gentleman named Norman Borlaug. He hybridized a wheat around the 70s called dwarf wheat, which is still in use today. Dwarf wheat means that it remains this tall. Its height doesn't go above this. So it dies less and its production is also higher. So we went through, and the same thing happened with rice, by the way. Okay. A variety of rice called IR8 came around the same time. Today, predominantly rice, that's the origin of the rice we eat today, is a descendant of that, basically IR8. This also came during the Green Revolution. Again, the purpose was the same: to increase the yield of rice because we have to feed our population. This was very successful, by the way. Meaning, a manifold increase in the yield. And we also made these crops resistant to diseases, animals, and stuff. So this hybridization worked really well. But one thing that this hybridization did was that it changed the structure of the grain. A grain typically has two types of starches: amylopectin and amylase. Amylopectin is the problematic one. That is pure starch. So after this hybridization happened, our grains, wheat and rice, contain a higher amount of amylopectin, which is basically a type of starch that readily converts into glucose in your body. Okay? So at that time, to feed our population, we went through this Green Revolution, and it was very effective, but we fundamentally changed the grains that we are eating today. So when people tell me on Instagram that our great-grandfathers were eating this, so how can it be bad today? The answer is that your ancestors were not eating the same grain that you are eating. You have to first of all understand that. So that is how we were led here. The grains that we are eating today are not the same. Now, if I talk about fruits. The fruits we eat today. You have archaeological pictures of these fruits, historical pictures, archaeological surveys. And many of these fruits that we eat today, their wild forms also exist today. Go on the internet, research. The same fruit, banana, watermelon, apple from 200 years ago. You will find an archaeological reference. You will not be able to recognize the fruit that you are eating today. The food we are eating today, the fruits we are eating today, have been engineered for two things: one, to increase yield, like we did with grains before, for higher yield. Second, if the yield is higher, then it has to be sold too. You have to make it taste better. What is our biggest thing? Sweet tooth. Sugar content has gone up. If you pick up a 200-year-old banana. You will find its appearance very different. Earlier, bananas used to have seeds in them. They had less sugar content and were much smaller. If you pick up an apple. Apples were this big 200 years ago. They used to be bitter, with very little sugar content. If you pick up a watermelon. You can easily find pictures of watermelons on Google. I have seen it actually. Watermelons that we eat today, their red part is the largest, right? How sweet they are. That was not how watermelons were supposed to be. Earlier watermelons had a smaller red part and a larger white part. They had more fiber, less sugar. This has happened over a period of the last century that they have been hybridized to increase yield and secondly to improve the taste so that we consume more of it. See, wheat is not the same. Like we used to eat it before, it is bad today. Then gluten is bad for us. We have talked a lot about it. Then fruits were not like they are today. Recently, Singapore banned spices from Indian spices in Singapore because Singapore said that Indian spices have carcinogenic traits, meaning they have cancerous elements. So now even spices are a problem. So nothing is right, is it? Wheat is not right, spices are not right, fruits are not right. So then what is right? It's not like that. It's not like that. I tested roughly about 10 different flours, eight different types on CGM. Okay? Because I and you know, my CGM results will be very different from your CGM results. So this is not an absolute truth for you, but directionally it will be the same. Okay. Okay? Directional insights will be the same. I tested many different types of rotis. Because roti is made at home.

It is made daily, friend. In my house, Mom and Dad also eat it daily. So what I found in my test was that there were two grains, barley and millet, that performed much better than this wheat. They gave me a much lower, much gentler blood sugar spike as compared to wheat. My hypothesis behind this is that barley and millet are not used very commonly. It has gone through less hybridization, and its processing is also done less. So you get it in a better form. It has more fiber content in it. In nature, carbohydrates always come with fiber. So when we, we process it and remove it. The wheat you eat. Which wheat do we prefer to eat? That Sharbati wheat, white. Absolutely, you know, when it comes to your house, whether you call it whole wheat. It is extremely processed. You are basically eating that part of the plant which has an extremely high amount of starch because we have removed everything through processing. Do you remember 5-10 years ago? I am sure you will remember this, or maybe 20 years ago. In my childhood, there was coarse flour and fine flour. Have you ever heard of that? Maybe you are too young for it. But when I was growing up, when I was, I think, young, in my teens or before, wheat was coarse wheat. It still exists today, perhaps. We don't hear much about coarse wheat. Coarse wheat meant that the entire plant, its husk, its fiber, everything was ground. So it was called coarse flour. Now we don't eat that. No one has a preference. We don't like it; the taste is not good. We want Sharbati flour now, or you know. So it's not that everything is bad. You have to understand that the food we eat, the majority of it, is very, very different from its natural form. Take rice as an example. Which rice do we want to eat? That big Basmati. That is the most processed rice that you can eat. Rice originally comes in its husk. You remove the husk, of course. After that, there is bran. Inside that is the endosperm. The endosperm is basically the starchy material that we eat. When we process rice, when we first remove its husk, then brown rice comes. Then we take brown rice for polishing. We take it to an extreme. Basically, we remove all the fiber, all the good fat, and eat only the starchy part. So if you want to eat rice, okay. As you said, not everything is bad. Choose the right rice. People lack awareness. If you want to eat rice, the variety matters less. Whether it's Basmati or Sona Masoori, that matters less. What matters is how the rice was processed. What flour do you eat? What rice do you eat? Do you feel that the flour that people still take to the mill today and get it ground there is better flour than packaged flour? It depends. If it is coarse flour, if you are grinding it whole, and along with its fiber, if you are not removing it, then it is better flour. So in my house, as I told you, first of all, I have controlled my carbs. I eat it only once a day. If roti is made, we will have barley or millet roti. They actually did remarkably better in my blood sugar test as compared to whole wheat roti, or even for that matter, Amrit or Emmer wheat. These traditional, very old ancient grains are better than all of them. They have undergone less hybridization. They are processed less. By the time they get to your plate. So that works. In rice, variety matters less. Whether it's Basmati or Sona Masoori, that matters less. How much it has been processed matters more. So when you buy rice, look for rice that is unpolished, raw rice. That will still have some nutrients. That will still have more nutrients like fats and fiber with it. It will give you a much gentler blood sugar spike as compared to processed or, you know, polished rice, basically. So it's not that everything is bad. You know, in fruits too, let's talk about fruits. You asked about fruits. See, the problem with fruits is that we eat fruits in large quantities. Hmm. And if that doesn't work, we juice the fruit. So the fiber that was in it, you've removed it. When you've juiced it, you are basically drinking pure sugar. You might as well drink Coca-Cola. So people who consider juice healthy, actually, try drinking it and testing your blood sugar. Your blood sugar will spike through the roof after consuming it. So if you want to eat fruit, please don't consider it a meal. Consider it a dessert. Okay? First of all, don't eat it on an empty stomach. Have it after your meal. Because then you have hopefully eaten a good meal, so it has some protein, fats, etc. After that, eat fruit. Eat in small quantities. Consider it as a dessert. Don't eat it in large quantities thinking it's a main meal. And please, don't juice it. And if you want to optimize even further, there are certain fruits that have low sugar content. These are non-tropical fruits. Tropical fruits are those that grow in tropical areas, like mango, you know, all of these fruits, for example, that grow in tropical areas. Because they grow in such a climate, they ripen more. And as a fruit ripens, its sugar content increases. So fruits like bananas, whatever you have, their sugar content is usually high. If you look at non-tropical fruits, those that grow in slightly cooler areas, they will have less sugar content. Basically, the berries, the entire berry family, for example, are considered non-tropical fruits. If you eat those, it's not that they have no sugar, but much less than tropical fruits. So pay a little attention to food selection. Pay attention to quantity. Don't eat it in large quantities thinking it's a meal. Consider it a dessert. Because it is a dessert. And don't eat it on an empty stomach. And please, for God's sake, don't juice it. Let's talk about if people are eating this sugar and there is excess sugar. You just said excess sugar in blood is diabetes, right? Eventually. Eventually, excess sugar in the brain leads to Type 3 diabetes. What did you say that? Uh, so neurodegenerative diseases have a very close link with metabolic disorders. They are actually part of the metabolic cluster that I told you about. They are part of that disease. Type 3 diabetes. Scientists call it Type 3 diabetes today. Explain to people what Type 3 diabetes is. Type 3 is just a name given to neurodegenerative diseases, dementia, Alzheimer's, etc. What happens in this? It's basically you are forgetful. Usually, in old age, you will find people becoming more forgetful, right? And brain functions are compromised more. This is usually seen more in old age. As I told you, in our Indian population, 20% of people are up to 50, and more than 60% are above 60. And if we are seeing the diabetes crisis today, we will be seeing a dementia crisis in 2050. The simple reason being that insulin resistance has a direct impact on your brain health. There are various mechanisms for this as well. Just like I told you about the heart. There are various mechanisms for this as well. First of all, it was previously believed in the brain that if you have Alzheimer's, there is a protein called amyloid that is found in excess in your brain, and that causes it. Actually, insulin is called a protein waste. Insulin has a very important role in clearing that from your brain. So if your brain is resistant to insulin, then that ability goes down. I told you that insulin plays a very important role in memory formation and learning. Memory formation, which is the hallmark of dementia, and learning ability are deeply impacted. The third mechanism is that if you are not in a ketogenic state, your brain is highly dependent on glucose, right? It needs glucose to function normally. Now, you are insulin resistant. So your glucose supply or energy supply to the brain is compromised, which makes your brain less efficient. So there is a very undeniable relationship between insulin resistance and neurodegenerative disease to an extent. There is research that was, and I have cited that research in my book, in which the brains of people who had dementia were analyzed later. And they found that the insulin receptors in those people's brains were defective, which is basically insulin resistance. So science has now come to a conclusion that neurodegenerative diseases are, that's why they are called Type 3. They are being called Type 3 diabetes now. We talked about Type 3. We haven't talked about Type 4 yet. There is Type 4 too. I mean, with insulin resistance and high sugar in my body, first I used to get diabetes. Then it appeared on the skin that too much sugar would cause more wrinkles on the skin. Then came fatty liver, that if there is too much sugar in the liver, it will cause fatty liver. Then too much sugar causes memory loss, dementia, Alzheimer's. People start losing coordination, their brain's coordinating abilities decrease. All this was not enough. The title of this is "One Dysfunction, Multiple Diseases." Because its branches, as I told you earlier, insulin doesn't just control blood sugar in your body. Insulin impacts every cell. How every cell processes energy, insulin decides. Memory formation in your brain, insulin decides. How your liver processes fat, insulin decides. Whether your sex hormones will remain balanced or not, insulin decides. It has branches, right? It has branches. That is why it is called a cluster of problems. Metabolic dysfunction is a cluster of problems. It is not one disease. It is a cluster of diseases. Type 4, it is a Type 4 diabetes is a relatively new scientific term. This is typically referred to as fertility issues. Okay? Fertility issues in women, the most common is PCOS. Okay? As I said earlier, a few years ago, PCOS used to be common in women in their 30s and 40s. Today, it is happening in teenagers. There is a study that I have cited in the book. They found that in India, one in five women of reproductive age has PCOS. That means 20% of the women population of reproductive age has PCOS. So it is very widespread. It is getting younger. And there is another research that says that 70% of PCOS cases are driven by insulin resistance. The mechanism for this is very simple. I'll tell you. Again, there are three or four mechanisms. Basically, when your insulin is high in a woman's body, what it does is it actually promotes the growth of androgens. Androgens are similar to the male hormone testosterone. So women with PCOS will have high levels of androgens, test, which means testosterone in their body, and low levels of estrogen. That is the opposite of what they want for good ovulation. Yeah. Okay. So that is a direct mechanism that insulin resistance impacts. But normally, this problem doesn't occur because your liver produces an enzyme called sex hormone-binding globulin (SHBG). Okay? What does this hormone do? It's a fallback mechanism. If a hormone is increasing, this enzyme will bind with that hormone and bring it to an inactive form. This is a defense mechanism built into our body. So basically, in a woman who has PCOS, her body will produce this SHBG enzyme in normal cases, which will bind with testosterone and inactivate that testosterone. But unfortunately, in insulin-resistant women, the production of this enzyme is hampered. So now they have not only high testosterone, they have high free testosterone, which deeply impacts their ovulation health. Second, actually, this is for the second, third mechanism. For a woman to have ovulation, you must have heard of the balance of Luteinizing Hormone (LH) and FSH. A ratio of hormones needs to be maintained. So what does insulin do? It increases the production of Luteinizing Hormone, and FSH remains low. So your LH and FSH ratio gets disturbed in women who have PCOS. That further promotes the production of androgens. So problems arise. Okay? And then, what is the last mechanism of insulin? I think I'm telling you the third one now. Insulin is a growth hormone. Or anabolic. For the follicles in the ovaries to mature, they need insulin. Only then can they mature. Now, if you are insulin resistant, those follicles cannot mature. That is the polycystic part of PCOS. These four different mechanisms of insulin resistance together cause PCOS. And it does end. It's a vicious cycle. When your insulin is high in your body, testosterone is high, SHBG is low, that will promote fat gain in women, mostly around the visceral area. That's why women with PCOS struggle with their weight. It's a vicious cycle. Now, the fat you store in the visceral area is inflammatory fat, which makes insulin resistance worse. So it has a vicious cycle. I have heard about men. So excessive sugar and insulin resistance in ovaries cause PCOS. Insulin resistance causes PCOS. Excessive sugar causes insulin resistance if you have it for a long period. A long period of time, if the diet is entirely promoting it. Excessive sugar causes insulin resistance, and insulin resistance causes erectile dysfunction in men and PCOS in women. Understand how erectile dysfunction happens. So I might have told you earlier, 27.5 million couples in India are struggling with fertility issues. Research says that out of them, 40% of cases are due to male infertility. The number one cause of infertility in men is erectile dysfunction. Earlier, erectile dysfunction was an old man's problem, occurring in their 40s and 50s. Today, erectile dysfunction is extremely common among men in their 30s. Okay? And there is research that says that one in ten men has erectile dysfunction. So it's a big problem, it's a big problem, boss. Now, insulin resistance plays a key role here too, unfortunately. And here it works in reverse of what it does in women. Here, insulin resistance promotes aromatase activity. What is the function of aromatase? It converts testosterone into estrogen. Insulin directly promotes aromatase activity in men's bodies, which converts their testosterone into estrogen. So men who have erectile dysfunction will have high levels of estrogen in their bodies and low levels of T, which is the exact opposite of what you want for a good erection. This is one mechanism. The second mechanism is a direct impact. For a normal erection to happen, your blood flow has to reach the male organ. So upon arousal, your blood flow is what helps you in getting the erection. For blood flow, your blood vessels have to dilate with nitric oxide. That nitric oxide is produced by your endothelial cells. Insulin directly opposes it from making nitric oxide. So now your blood vessels are not dilating properly. So the blood flow is not reaching the male organ properly. Hmm. So obviously, achieving an erection will be difficult. I have explained a fundamental in my book which I have called the Big Rocks Principle. Hmm. Okay? What is it? It's not my principle. I have actually taken inspiration. It is a time management technique. The Big Rocks Principle of time management says that imagine you have a glass jar in front of you. Hmm. Okay? And you have some big rocks with the glass jar. Big rocks. Some small stones, pebbles, and some soil or sand. The big rocks represent your top priorities, the most important tasks. The small stones are miscellaneous important tasks. The sand is the trivial things. Now you have to fill this glass jar with these three things. There are two ways to fill it. Either you put the sand and small stones first. Once you put those in, there will be no space left for the big rocks. So you have done your trivial tasks, but you couldn't do the most important one. The second way is to put the big rocks first. And let the sand naturally settle around them. Then you have taken care of your main priorities, and the sand has naturally settled around them. So this is the Big Rocks Principle. So I have taken inspiration from this time management technique and applied it to metabolic health. It applies 100% to metabolic health. You can do many things to improve metabolic health. You can take supplements. You can do biohacking. But boss, if you don't get these three right, nothing else matters. Okay? And the three big rocks of metabolic health are nutrition, your activity and exercise, and third is your stress and sleep cycle. These three will have a deeply meaningful impact on your insulin sensitivity, which will have a very meaningful impact on your overall metabolic health. Okay? I'll also tell you why I chose these three. One is due to frequency. The average person eats three to six times a day. High frequency. I think almost everyone sleeps at night. High frequency. But we are also active. Now, someone like me, I move my hands a lot while talking. So that's also activity, right? So activity, we do it all day. So the frequency is high. So one reason is their high frequency. The second reason is that they have a direct impact on your insulin sensitivity. Direct impact. So that's why these three are my big rocks. I believe the best exercise is the one that you will do consistently. Hmm. So if you like running, swimming, cardio, whatever, just do it. Because not every exercise has a positive impact, right? A massive impact on metabolic health, right? But research says that if you want to optimize, to be optimal, then strength training is the best form of activity for metabolic health. The reason behind it is again, when you do strength training, and by the way, when I say strength training, it doesn't mean you have to lift weights in the gym. Because many people can't do that. Right? You can do it with your body weight too. Planks, squats, push-ups. Pull-ups might be difficult, but still, right? You know. So with body weight, you can basically, the idea is that your muscles should be used. Because when muscles are used, as I said, one, they deplete glycogen stores, so your muscle's capacity to refill will increase. Second, if you increase muscle, your glucose disposal sink also increases. Hmm. So you will have much better metabolic health because of this. So if you go for optimal, then incorporating strength training, ideally four times a week, in short sessions of 40-45 minutes, is more than that. That's the optimal range. And the third, you said sleep and stress. Sleep and stress. Yes. And it has a very direct impact on insulin resistance. Let's start with stress. See, stress, in our body, there is a very sophisticated stress response system. This also comes from evolution. Hmm. If you go back, say, 1000 years ago, life was very different then, right? You are in the wild, imagine, and a lion appears in front of you, right? So what will you do then? Your body has a stress response system called the HPA axis. Its job is to mobilize resources in a stressful situation to give you instant energy. Hmm. So when you are in a stressful situation, this HPA system activates and produces cortisol. Cortisol is one of the stress hormones. Okay? Cortisol, and there are more stress hormones, epinephrine. In many places, it's called adrenaline. These stress hormones do what? They immediately produce new glucose in your body, without food, so that you can get energy and escape from that lion. Hmm. This is a very sophisticated evolutionary stress response system built into our body. Now, what is happening is that today, we don't have lions appearing in front of us. But today, we have constant stress. Chronic stress, as it's called. Okay? And that could be for multiple reasons. Stress at the office, stress at home, traffic, arguments, right? Yesterday, I was stuck in Mumbai traffic for two hours. That's stressful. So that mobile phone also, constant notifications, reels, dopamine, right? So even though it's not directly causing stress, it's keeping you in an alert state, isn't it? So we live in chronic stress today. Earlier, when this, earlier what used to happen was, hopefully, you escaped from the lion, and then your stress levels came down. Your cortisol returned to normal, right? So it was supposed to be a temporary thing. But today, we find ourselves in a chronically stressful situation. Which means our cortisol levels remain chronically high. Cortisol has a direct impact on your insulin sensitivity. How? Cortisol first, as I told you, breaks down your glucose. Glucose provides you with energy. Cortisol directly opposes the effect of insulin. What does insulin want to do? It wants to bring glucose down. What does cortisol want to do? It wants to bring it up. So they are competing forces, right? So chronic elevation of cortisol will eventually lead to insulin resistance. One mechanism. The second mechanism is our visceral fat. The visceral area has more receptors for cortisol. So when you are stressed, you must have heard of "stress belly" or something like that. Why does that happen? That's why it happens. If you remain under chronic stress, you gain more fat around your belly. Because there are more cortisol receptors there. You might remember from our first conversation that I said that visceral fat worsens insulin resistance because it produces inflammation, right? So it has a vicious cycle. So that is how chronically elevated cortisol levels cause insulin resistance. So you can eat well. You can be active. But boss, if you are constantly stressed, you can still have problems. Here's the last question. Okay, you are an advocate of an animal-based diet. [Laughter] There have been enough researchers, doctors, scientists, nutritionists who say that vegetarian diets are better for you than animal-based diets. And this is an ongoing debate that continues everywhere. Until now, on the podcast, all the experts I've spoken to, including the top 0.1% athletes, they all prefer plant-based diets. You are the first one who has come who is like, an animal-based diet should also be taken. It's not that I promote animal diet to you. Okay? What did I tell you? My philosophy regarding nutrition is simple. Control carbohydrates. Don't fear fats. And prioritize protein. That is my principle. My principle is not whether you eat meat or vegetarian. I don't care. For metabolic health, these three, this is the simple rule for nutrition when it comes to maintaining metabolic health. If you can follow these three equations on a weekend vegetarian diet, then a vegetarian diet is completely good. But often, it doesn't happen like that. Vegetarian diets are mostly carbohydrate-loaded by nature. The protein sources are usually not great. You don't get complete protein from vegetarian sources, so you have to do combinations. How much paneer can you eat? If you ask me for the top three protein sources for vegetarians, they would be protein, sorry, paneer, tofu, and soy. Soy actually has good protein, right? These are the three things. Besides this, if you are vegetarian, where will you get protein from? Supplementation, then. So I am not a proponent of vegetarian or non-vegetarian diet. I am true to my principle. My principle is: control your carbohydrates, don't fear fats, and prioritize protein. Which I think is a bit difficult to do on a vegetarian diet. Not impossible. A bit difficult. So please, you stick to your vegetarian diet. But follow this rule. Reduce carbohydrates. Incorporate good fats into your diet. And plus, prioritize protein. If you can manage this, then a vegetarian diet is totally fine. Fair. So you are not like promoting which diet is superior or which diet is inferior. It's just prioritized protein. Prioritized protein, control carbs, and incorporate good fats into your diet. Well, thank you so much, sir. Thank you for it. It is my pleasure. Raj, it's such a pleasure. Pleasure being with you. It's my pleasure. How are you? How are you? It's actually unreal to be here, man. I mean, I have always seen you on TV. You know, how it happened? Your book came out. Did you self-publish? No, there's a publisher. Oh, I sent it to you. [Music] Hmm. How it reached us, we don't know. Usually, most books get lost somewhere. They don't even reach me. This one reached me. And I was like, just so titled. I was like, I like it. And I immediately opened it. I read the table of contents. I said, we need to talk. And immediately on that day, we decided we should have a podcast. I guess, so I guess it worked. It worked. It definitely worked. So whoever thinks that getting on a retention is super hard. But getting on a podcast is super hard. That I can tell you for sure. Thank you so much for watching this episode till the end. Now you have to do three things. First, subscribe to this channel because the more you subscribe, the better and more valuable guests we can bring for you. Number two, tell me in the comments what you liked and what you disliked about this episode so that we don't repeat those mistakes. And which guests would you like to see back on our podcast so that we can bring them and provide you with maximum value. And number three, share this episode with at least one person because one conversation can change someone's life. I will see you next time. Until then, keep figuring up. [Music] [Music]