The Shocking Reasons Your Diet is Failing Your Gut Health | Top Nutritionist Sangeetha Aiyer

fiber is the bread and butter a lot of vegetables which are high water content squash pumpkins bottle gold these are all vegetables that have a lot of water content so they along with Mo the gut should be protected protect your gut okay feed your gut protect your gut for the past 100 years you have heard eat more fruits and vegetables eat more fruits and vegetables I will always insist start your morning with ghee water end your night with ghee water just go to YouTube and type protein deficiency in India you will get at least 50

videos that say that the primary home maker at the wife the mother they don't even understand the concept of protein the one thing that works beautifully in my practice to heal gut bone broth we know that if there is no adequate protein there is sarcopenia there is bone density loss the mortality in older people is once they fall they're unable to get up you may do well with a Cho chart at home but a Cho batura outside maybe problem because the eating habit is so poor we discussed right lot lots of ordering lots of Maggie

cooking can't exercise it's okay your kid is going to school then you have about half an hour instead of scrolling the phone can you just walk around a little bit a lot of influencers dietitians on social media are talking about this you know what is this genome mapping what the heck is that hello guys welcome welcome to another episode of our podcast series gut feeling with Dr pal we have Miss Sita AER again you know we had a wonderful discussion in the last episode we decided to do another episode going deep into the nutrition aspect

given the nuances that we discussed on the previous episode and I absolutely enjoy this episode we discussed about the most important criteria of the gut which is fiber what is the Practical problems in Indian Community in taking fiber what are the possible options that you could do to increase the fiber intake and is really fiber is important or protein is important if you are a vegetarian should you focus on the fiber or on the protein was wonderful discussion that we did more importantly we really went deep into the molecular level of why any non-communicable disease

is happening for example diabetes hypertension all these diseases should start somewhere and be figured out what is that particular thing at a molecular level and what is the final solution for it as well I'm sure this is a lot of information it could be technical at sometimes and if you can follow through the whole conversation I'm pretty sure you'll understand the context please stay till the end to understand the whole concept so that you will understand the overall clinical picture anyways I'm so excited for this episode let's dive deep into it hi again Sita hi

Dr so good to uh talk to you again uh we had a wonderful episode we talked about a lot yeah we talked about a lot I'm was a it was a wonderful discussion absolutely likewise it was a wonderful discussion I think the the the learnings from your uh clinical practice the medical side of things the the nutrition side the symptomatic side of things I think it was a great was a great discussion hope audience learned a little bit including me I learned a lot from you same here so in this episode I want to focus

on my favorite topic which okay fiber okay okay why did I even ask which might not be your favorite I fall on both sides of you fall on both sides of this is my experience but yeah we'll discuss it so um first of all right right of the bat I'll start with the clinical scenario similar to how we talked about so being a gastroenterologist all I see in the OPD is bloating pain but one of the most common thing is constipation I would agree huh most common thing is constipation it is not the diarrhea we

also see diarrhea as well but the most common thing is constipation it is tied down to a previous discussion of slow intestinal motility Mobility yes it's called most of the times it a slow Transit GI motility and we talked about this that brain gut access is there there's a connection from the brain to the gut and the Brain should send signals to the gut gut should send signals to the brain so that the let's say you eat budy or Bond or something it gets digested it gets goes to the next place when this connection is

weak broken or weak H weak then the motility is not there then that's where the constipation is one of the biggest treatment option that we have as gastrologist is fiber and the reason for fiber is that fiber increases the colonic morality number one and it also absorbs water as well and increases the colonic water retention um and it helps to excavate the bble I'm sorry excavate Evacuate the bubbles that's we should do I hope no excavation is Ever Needed there ever we do excavation I know that the colonoscopy is a no Ana manual FAL disimpaction

I'm not even kidding are you telling me that you put your I put my finger in and I take the whole stool out it is an emergency almost all this old patients paraplegic patients Parkinson's patients so basically they've lost the motor skills and everything there a CT scan there a huge stool ball sitting right there in the rectum and the emergency room will call you at 1:00 a.m. in the morning I'm so glad I'm fasting no I I'm kidding it's very painful it's extremely painful and they want to make sure that the bbel is not

perforated it significantly distended and before putting a colonoscopy inside this is the simpler way because colonoscopy you put it inside it might rupture the right so perforation is a complication so once I go at 1:00 a.m. to manually disimpact that's what gastroenterologists do tough chob on the way to the hospital I called my mom huh uh I said my uh I said I'm going to the hospital she said what time she said she said 1 a.m. wow you're so busy and everything she called my uh I was afternoon here inia right right she called my

mama and says my son is a very busy practicing Gastrology see what are he is doing mom asked what is he doing I said I'm not going to tell you yeah but so anyways so coming back to this it's that U you know we so constipation yeah we always give fiber water and fiber yes we always give fiber yeah and we have figured out that any gastrological problem IBS IBD low fiber is a precipitating factor for most of the symptoms one of the most common symptoms is hemorrhoids yes for hemorrhoids when you're bleeding correct that

is because of the constipation you are and then moves into Fishers Fishers and everything right correct I have lots of Cl problem the treatment for hemorrhoids is fiber because once you get rid of the constipation and the colonic motility problem then there is no strain on the blood vessels in the rectum then there is no hemorrhoids then there is no bleeding nothing but let's say the hemorrhoids are very Advanced and constipation not being taken care of then no matter how much fiber you do you cannot do so you do ban liation of the hemoroids but

bottom line I'm trying to say is fiber is the bread and butter for us that's why I have Geo Network because Gio F very bad joke bad joke dog that to now that they've increased their prices after the mega wedding you have put your finger on a very painful so I tell my patient is that every day uh I mean Gast recommendation as well is that minimum 25 G of fiber per day in women H 30 35 G of fiber in men H what do you do in your practice I'm almost scared to tell you

okay see uh doc I'll tell you very honest I have read all if not all majority of the literature that is created in the form of studies rties metaanalysis I follow apart from you a lot of people who are big uh on fiber and very legit not necessarily with a bias to animal based or plant-based because those are very two different conversations one side says no fiber but I want to tell you and when they come to me they have in and let's talk very specifically IBS IBD Conti all the the spectrum of IBS IBD

in some cases it is so bad the the medications give them heart palpitation they have to go into the ER they can't tolerate anything U malabsorption all of that so now when people come to me this is their line I have done everything I have had this condition for 2 years my first question is have you visited a doctor let me rule out so I start with ruling out I say have you ruled out uh sibo with the doctor leaky gut have you ruled out H piler very common infection which you cannot solve with nutrition

okay I rule out all of this they say yes I've been to the doctor I don't have this I don't have this the doctor said IBD I have been on medication for 2 years no matter what I do it doesn't help resolve me now I also know that as a gastroenterologist it is hydration and fiber I actually do the exact opposite doctor and I start my elimination protocol the first thing I take away is raw vegetables because I believe that first I need to start letting the person eat something feel better give that gutter rest

without those scamping and either constipation or diarrhea uh and bring them back to basic Baseline before I start reintroducing foods that will help them solve the root problem and I do agree with you that they probably reached the state because of low fiber and there could be 10,000 Reasons it could be bad lifestyle it could be junk food it could be sugar many cases anxiety uh mental health is related to uh uh you know like a uh IBS condition so when they come to me it can be from like I I'll tell you a case

study later but it can be somebody who suffered it for 10 years and they live with it do they live with it saying that oh today this happened I'll pop this even further we know what um laxatives antacids they further destroy we know that you've spoken about it they put a banded on it to the extent but when they come to me it's it's a very bad state that they don't know what to do so I have to go the other way and say let me first remove what irritants I know and this is trial

and error let me tell you it is different for different people because your gut microbiome is like your fingerprint what I remove for you will not be same for same for me but having said that there are some commonalities okay first is raw vegetables because you need to have a really well well programmed diverse gut microbiome to digest anything wrw that is commonly known in in nutrition and in a Circles of difficult to digest very difficult to digest because you have to have robust cor stomach acid and microbiome to handle that we already know that

there is compromise there so the first thing is I take away anything that is raw okay so take away that and mostly vegetables um then I I will even before I take away raw vegetables sugar starch junk food uh excessive sugar consumption needs to go without that I don't start this protocol because I tell them that I mean one end I'm trying to resolve by removing uh fiber and doing things other end if you're going to feed yourself buia and Coke every day it they it doesn't work so that is without a brainer that I

drop that and I drop I tell them to go sugar-free for a very long time so no no process sugar not even and tea and coffee when it comes to that sensitiv the next is um raw vegetables third I take away starch because molecules of sugar that don't that don't sit in that condition ultimately starts as molecules of glucose it don't allow uh to sit in that condition when the gut microbiome is that way okay so a lot of sweet potato potato a lot of that I take away okay the third thing I take away

which is I know you will not like it but but it is a third goto legume M most people the only thing that they tolerate in plant uh especially in the lentil legume category is all forms of Mo they are very good with moong Sprouts again not raw cooked Mo sprouts cooked because a lot of people consume Mo Sprouts robw the geration the germination procedure actually can cause gas in a lot of people it can cause flatulence so I take away the entire category of ch rajma now you you will ask me what is left

okay so water yeah so depending upon who it is if it's a vegetarian or a non-vegetarian the challenge begins if they are even lactose is problematic which in many case they are when they are intolerant to all of this sometimes paneer also goes out of the scenario okay then cold milk a lot of vegetables which are high water content squash pumpkins um your um in Hindi we call them T Turi and look this one your snake go water your bottle gold these are all vegetables that have a lot of water content so they along with

mo mo uh if if they can take a lot of curred yogurt in their diet and the one thing that I bring in is fat like empty stomach coconut oil m so this wisdom I've drawn uh from uh our grandmother based wisdom or you want to I and I follow A lady called babra O'Neil who's very big uh uh in using plants as medicines fat is the original aiff uh Even in our own culture we know that when a baby is highly colic and constipated grandmothers have put some kashaya they make their own thing and

they'll put it either with they mix it with breast milk and some ghee and in chronic condition they will put it in Castor oil C oil correct very common in the South all grandmothers have done it all across corre so there is a little bit of a we also know that fat like good fat coconut oil MCT oil ghee they all kind of act as a lubricant to the entire system now when I'm not able to give fiber because that is one trick the other thing is when I make the digestion easy with fermented food

and things like vegetabl some rice I take take away wheat as well by the way uh some fruits I will always insist start your morning with ghee water end your night with ghee water over a period of time they will be able to pass that that that motions and the bowel movement becomes easy uh soluble fiber like isab go to form does help so I encourage that if you're a non if this is vegetarian if you're a nonvegetarian nutrition planning becomes slightly easy because contrary to what you may think you digest animal protein very well

so if if it's a extreme case of IBS IBD I take away all these same things um some people do not tolerate eggs and shellfish depending upon what is their allergic nature and if that is causing an irritation but chicken mutton mints uh fish soft protein they're able to handle so for me in a in a meat-based person the basic nutrition at least 70% of it I can handle because there is basic protein then I add again yogurt CD the one thing that works beautifully in my practice to heal gut bone broth so in our

cultures it is there as paa and this and that so good bone broth made at home with minimal spices don't make it like a like a restaurant version version of a bone broth just salt pepper basic ginger garlic basic spices slow cooked bone broth every day it's like a shot 200 mL on empty stomach has a lot of collagen has a lot of um good protein good fat that is coming from the animal and over a period of time other things that we can use cafir fermented so like buttermilk like Kur there is cafir now

you get coconut cafir you have grain Cafe you have milk CFE all available India so my whole thing is first can I take away the irritant which are I know all these things now person to person one person may not tolerate broccoli other person may tolerate something cruciferous is again they don't tolerate very well in the initial uh phases beans cage cauliflower cabbage cauliflower broccoli brussel sprouts they don't tolerate that in the beginning so it is all your mushro brussel sprouts is here very rarely very deely so yeah very common so first build their Baseline

nutrition now this is where animal diets and my advocacy for animal diets com let me just interfere what you exactly said right H this wrong no no this is what exactly happens with my GI diation uh in in in my practice so I think the difference of angle is you are talking about IBS patients right where the brain get access is imper already in that patient what we do the GI dietitian and me will do something called the low for map diet as we talked about for map means fermentable oligo D monosaccharides and polyols correct

okay all the thing that you said raw vegetables cabbage coliflower everything will come under the low form so I'm doing absolutely right you're absolutely right I'm so glad like an Indian ditian is doing this because this is what we are lacking in the US yeah and Indian comes to me I said low F map diet they go to the US ditian they don't yeah they don't understand TKA they don't understand anything so that's why I train my G ditian who's an Indian as well and then we do everything what you're talking about correct we take

everything out yeah in same doc even sometimes I will not allow I know the the love for millets is great in this can you understand where I'm coming from the brown rice wild rice millets I trust me white rice is the best when you're struggling actually because Millet will come under that oligo thing so I do this for one month and this is the client where I am on their uh I'm on communication with them every day and I design a score I have five points on which I desire a score okay bowel movement flatulence

uh feel good okay restful sleep so on each on a scale of 1 to five they have to tell me and I will exactly know that day what they've eaten I anyways monitor it bya logs and all of that over a period of time say over 4 weeks I have gotten let's say from zero which is the poorest score I have come to three now which can be 3 weeks which can be four weeks now I start reintroduction slowly I never you have to reintroduce very slowly now I will reintroduce let's say toal okay or

I will reintroduce brol okay night shades are again a big irritant in uh this one then I will watch it then I they'll say okay no yes bad ugly then I will reintroduce now this is the process of give and take give and take give and take that goes on and normally minimum 3 months it's not a shot I think 6 months three month for me minimum to get to get things and at the end of 3 months the the the question the audience Must Be Wondering does that patient go back to nor normal may

may not depending upon what your definition of normal is okay and depending upon the damage as well and damage as well absolutely can that person go back to eating almost anything and everything as if nothing happened maybe not okay but can your quality of life improve almost by 70% wherein I have identified all the critical Group C C Food categories which are needed for nutrition and you're able to tolerate at Le two three that will happen very rare cases a certain group completely goes out of the window very rare but that time now the the

thing is people tell me now if I want to eat Cho what do I do I said now then it gets into advanced microbiome testing corre finding out what pathogens are there which is an expensive process so I have I have to comment on this sorry no I'm so sorry uh because this Advanced tool testing to check the bacteria huh huh I think since I come to India more frequently because of social media I am seeing a lot of testing has been done unnecessarily I want to say the same thing you know know your bicro

microbiome and know your stool bacteria do you and Doctor it I'm not saying it is completely useless I'm saying the outcomes Even after spending that much money it's not guaranteed to like for example if I test your fasting insulin for, rupees in any lab I know my actionable what I can do to bring your fasting insulin to under to a single digit number if it isn't double digit I know what to do to your triglyceride I know what to do in microbiome it's a world we don't know it is useful in a particular set of

patients I'm sure you know where we can only see okay this is a group of good bacteria that he has maybe this is what the problem is then we do interventions we follow it up 3 months later see whether there's any change that is an extremely small number of group patients will let's say 100 patients come to IBS with us one patient will get the testing qualifies to get into that kind of Investigation correct yeah here I think everybody is getting it because that's why a lot of influencers dietitians on social media are talking about

this you know what is this genome mapping what the heck is that I I I have no idea like uh 23 and me DNA testing doesn't exist for this side of the world I mean that is 2 billion and 3 trillion what is this and then there is a lot of this microbiome testing genome something then know your ancestry and through that yeah so this is a evolving thing and there's a lot of good testing techniques and availabilities happening but we are not there yet maybe 5 years from now we will be able to identify

okay so this particular bacteria will be able to do this and everything but we definitely not there yet yeah so but I completely agree I just interpret you because that's toool testing and everything should be thrown out of the window for most of the patient yeah I think there has to be very critical parameters as to who is a candidate going in for that uh and it can't be anybody with IBS GI problem gastritis it can't be anybody anybody and truthfully people get upset you know maybe fellow uh people health professionals this I said people

don't have money to get Once in a year a blood test done they're very they're thinking 10 times about it forget that when there is a serious hospitalization in the family it's very taxing financially on the family I mean to do all these Advanced sort of testing which again has no proven outcome so coming back so this is what I do and then over a period of let's talk about success parameters success parameters are mainly 70% of your lifestyle your quality of life gets better I will be hopefully be able to arrive at like I

said if we have groups of food like carbohydrates starches fruits protein fiber I will be able to arrive at at least three to five foods in each group give you a universe of nutrition so to speak that you can easily eat with a set of do and don't saying that outside eating be careful for example or if you're venturing into you may do well with a Cho chart at home but a CH batura outside may be problematic so I will conclude that and they're very happy with that because from where they come first medications go

away then all these crazy symptoms go away and then this is so this is basically the opposite I do in my practice so I may not be able to go completely high fiber but in some yeah yeah I think I'm sorry what I'm trying to say is this is the treatment for IBS what you're saying is a treatment for IBS this has been proven what you're doing is exact same thing you know you eliminate the diet and make sure that you don't eliminate for more than 3 months correct and then you reintroduce so that you

don't lose the micronutrients and it's like a baby yeah right you're taking it out and then giving it a new birth and then you're slowly reintroducing and that elimination I have realized because the gut is not confused there is no so much stress on it it's like you're slowly healing the gut with things like bone broth and fermented food like kurd when I do S Craft and kimchi I tell them don't do the high chili version Don't Do sensitive things but reintroduce all of that then slowly you rebuild so that the gut can can it

handle like a cauliflower now can it handle tomato of course of course slowly and then let's say that you're not able to handle cauliflower C goes out comes back again tomato something like that something like that yeah what I was mentioning initially was a patient for a good gut health without a problem so let's say just constipation can be multiple things IBS constipation is different yes slow Transit G motility is different correct what your approach will not work for slow Transit uhuh what you are saying is IBS with symptoms correct bloating pain correct but most

commonly it is the slow transil and normal people normal people when they come and ask me okay how do you improve the gut health it's fiber no so correct probably I'm speaking from my own experience I get the former not the latter I don't get so by experience I get this really severe GI patients you come to California for the practice I'd love to I will give you an example of a this is a 2022 case a 36-year-old man contacted me uh and said since the age of 14 I have had some sort of IBS

IBD problem I've been to various doctor so now he's saying since the age of 14 I don't even want to go into the history of what he was eating I know that there is considerable damage done so I said he says any my quality of life is so bad okay and D client NOA client that I have not taken a holiday in four four years I don't even travel because the thought of me leaving NOA and reaching the Delhi airport means I have to map where uh bathrooms are and if I go out I have

to first figure where is my bathroom what is if I have a gut problem what is my insurance so I don't travel we had a study on this IBS diarrhea um where what is the quality of life compromise that's happening for an IBS diarhea patient the control is cancer patients wow okay control the cancer patients Believe It or Not IBS diarrhea patients the quality of life is much much worse than cancer patients my God this I didn't know imagine it is painful for me to hear clients when they say this it's it's when when you

have the disease you will be surprised in the way that it completely changes your life I can I I've SE so many patients like that yeah so he said I can't go so we worked together for eight months it was a very slow process it had reached a point where he couldn't even tolerate normal spices doctor so just salt pepper Hali just salt pepper and eggs and meat for almost 6 weeks with bone broth and dairy then slowly slowly slowly with him I still could arrive at only 15 foods he could eat but we did

Blood marker testing and all all his markers are fine he gained 3 kgs the proof of the pudding is this 11 months later I get a message of him with his daughter in a beach uh in Malaysia nice no so nice so nice yeah yeah so yeah and visibly he had he was lanky uh weight loss visibly little muscle mass came started exercising so I get these kind of like not this is very extreme but somewhere on this spectrum but I do understand the regular constipation the the the slow motility that you're talking about is

basically bad nutrition habits bad nutrition and U that happened because of the lack of fiber intake right correct so what I promote in my you Channel as well so look at college students do sorry I've interrupted Maggie in the afternoon where is the fiber night one they'll eat like two toasts of bread with some um uh you know uh this one that save and jam on there or it'll be just rice and Dal it starts actually when you get into college life and unfortunately if you're in a hostel because at least I think until 10th

we are under the guidance of grandparents Mom and Dad sorry you were saying um yeah no what I was saying was um so for in a normal normal person if you have fiber of 25 GS of fiber per day they will not even come to you yeah see that is the difference that's the difference so my question to you is I want I mean my this group of people where they don't have any G problems right now and I don't want them to Dev any problems no no fair enough absolutely so for that we recommend

25 G of fiber per in your practice in that group of people 25 G of fiber is possible yes or no starts with maybe 15 15 yes slowly okay see that group of people now they I'm telling you their eating habits is dominated by Ultra processed food that is what I have seen number one very sedentary lifestyle we all know that getting sun exposure going for a walk exercise is a massive probiotic if you if you are doubtful every anytime I'm telling this to the audience I'm sure you know you feel a slight bloat you

go for a walk or just do a 15 minutes strength training routine you will suddenly see a change in how your tummy feels I have experienced this 10,000 times the reason is exercise stimulates the production of short chain fatty acid called butyrate correct in the small intestine regardless of the diet it's very important very important very important regardless of the diet and it has been shown in studies as well correct so that's why so your question is the the the the the people who are normally come to me very poor habit the minute I change

that to A Whole Foods diet and come down see if they're at three and four G like I told earlier 25 G challenging yeah I'm telling you vegetarians don't want to eat 300 G of vegetables so what are all the why are they getting only three or four grams because the eating habit is so poor we discussed right lot lots of ordering lots of Maggie cooking lots of uh but how about homemade even in home you saying even regular so I don't I don't get under 18 year olds as much so it is not them

I'm saying all these about 20 25 yeah but let's say let's say I'll give you an example 32y old married couple huh okay they are both working so you are telling me working married couples I can only cook oh once or twice a week rest because of our schedule my wife travels to New Zealand the other day I'm on this hi whatever thing uh or uh I don't have time because my wife is on a busy schedule I am I'm sleeping at 11:00 and waking up at 5:00 to send my kid to school I see

uh my I'm delicated everything to my maid I don't know what my maid is doing so it just that busy lifestyle and the ease oh but I do try and Order healthy so there are they try and so where do you start from them so you start with grain you said no with such people I have to first give them a solution for their lifestyle no you eat this you eat that is not going to help I'll say I'll make life easier for you do you have a cook give your cook these instructions okay or

if you are somebody who can do meal prep uh every 3 days only this is how you do your meal prep this is how you steam your vegetables and airtight it this is how you pre- marinate your protein and keep it this is how you do it okay keep these Foods stock in your fridge strawberries these are all high in fiber orange okay take away donate all the ultra processed food now second thing can't exercise it's okay your kid is going to school then you have about half an hour instead of scrolling the phone can

you just walk around a little bit you have to give them solutions for their lifestyle problem problem and you also said 100 G of vegetables per meal I say at least 2 another 100 to 150 serving is fruit so fruit and vegetable will hit 300 to 350 beautiful I I go by 10 plant points per day huh uh right any nut seeds uh vegetables fruit everything but one cannot be repeated that's what so two oranges still one plan point at least based on my thing talk on on social media you can gamify things if I

gam ify with these people they'll say my boss is giving me targets you are giving me Targets on plant points now and fiber points so so I in the gutan challenge I came up with five plant points because I realize that people are not even getting the minimum five plan points that is so bad and for me where I I my my like you gamify work towards a much larger community and because I I do it with the set of clients so I for the first 3 weeks I insist I need to see your meal

picture insist so when that part of client on boarding now in that meal pick I will know how much fiber what is there I I and you won't imagine even in meat eaters even when there people think I'm very um meat forward which I am but I will never let a uh like just chicken grilled chicken be there I says where are mushrooms where is the vegetable where is the sauteed vegetable where is where is skir I said make it that so there they get I I very persuasive I need more vegetables I need more

vegetables I don't have time for breakfast it's okay I said you eat a a cucumber and a carrot in a Raa form in office so I do because you know why I do this when I'm transitioning people from uh which is what our diets are high carb high sugar diets to low carb if I don't I'm changing the input output will change if I don't count for carbohydrates to come from good sources like vegetables within one week they will call me and sing bowel m not happening constipation they're going to tell me that I already

know that so hydration water intake uh salt um uh walking um sleep and uh sleep and vegetables and fruits very important so all this will actually help uh the bottom line what you're trying to say is that the once you have the plan points the G bacteria gets repopulated and the fiber is will come eventually yeah and then it comes eventually so in case of IBD IBS elimination and adding like I said may not be all all everything on the under the planet but your quality of life gets much better in the other cases where

there is General constipation first give them ways to heal the constipation which I again do ghe water isab goal um do all of that goal is nothing but fiber fiber correct so first let us solve that take away all your bad habits in most cases they don't drink water doctor right yeah of course I'm telling you sometimes it can be as simple as monitoring their water intake water HH and then I will always say bring in um vegetables with water content get your fiber then plate monitoring show me your plate the the why hydration helps

is while you're drinking the water what happens is your stomach distance so that that's why I tell all my patients so 2 L of water per day is minimum you say and that is very important for all your digestive hormones to work better so imagine water as a water bed for all your lipas protein everything so it's just like jumping in Joy yeah and the other so how do you get 2 lit nobody's going to measure the water bottle that's going to be very difficult so I say one cup before and after each meal so

that's where the problem comes you know people say that you know are you diluting the digestive juices yeah things right there is no research to prove that exactly but there is research to prove that while you're drinking the water before means it distance the stomach the neurons from the stomach goes to the brain and suppress your appetite stimulation thinking that your stomach is elongated and full already and therefore you may not eat as much yeah so when I grew up my mom used to say don't drink water ra you cannot eat anything no after I'm

grown up children they always say this if you drink so much water what will you eat they don't realize that is what makes us 8800 kilos later on after they really grown up they say drink water ra don't eat that much I remember I used to complain a lot uh you know young age I was always plump dog so and you know I I always thought this is my destiny I was nicely plump so Mom would say uh in the gym alaana okay right I mean they said it in a certain fashion corre but they

knew concept the concept is that yeah yeah and similarly my grandom would say all the time when you walk into the house from school don't say I'm hungry I'm hungry I'm hungry it's not nice learn to control your hunger a little there's a lot of wisdom yes in the in and to translate in Tamil she would say your Tamil audience will know in the very yeah you know there are certain things that come out only yes exactly Grand moms would say that you know that's the first introduction of how do you experience comt discomfort discomfort

handle discomfort so um that's what we do yeah got it so I'm happy I'm somewhere close and aligned course of course you know hydration is extremely important and then so the point is if you drink one cup of 8 ounces before and after each meal so three meals so you'll get like six cups and then snacks before and after two snacks so you'll get your eight cups correct they come to 2 lit correct and then a little bit comes via watery vegetables and some all those are extra right there water content in food all of

that is there but this I make a rule all those water you cannot include in this yes in this correct agree if it comes it's as addition correct correct then I say one fruit per each meal okay and then they'll talk oh fruit to sugar and everything so I said dude you eat fruit so you don't get sugar later of course if you're a diabetic low glycemic like what you said goova is one of my best same here this the crunch has so much satiety in it and after that you're done also I'm so upset

that I California you don't get it even if you get it it is so costly yeah it's like your avocado imagine guava being your avocado it's very costly tomorrow I'll send you gift dog I'm getting you a guwa Goa is one of the wonderful wonderful rich in fiber rich in fiber low calorie and uh my sisters endocrinologist yeah she said that if I practice Endocrinology in India every patient is going to get Goa yeah yeah no it's very a my mom says you know I have a Goa tree at the back here we'll sell it's

the first in uh after Indian local berries uh okay Indian has India also has its own local Beres so um jamun is our berry the javap plum which is currently in season then we have FAL it's called in Hindi they're small maroonish in color I see so India has its own version of berries which unfortunately have disappeared out of major Towns now that I've gone back to Hyderabad and I have to take a highway road to reach my house on the highway I see those aunties selling in in that that no Supermarket selling so Indian

berries are my first goto and of course strawberry now is there I still tell people wash strawberries very well High pesticide content then immediately guaa citrus fruit oranges yeah so these are even standard even in my my list and any other fruit you want to eat like high fructose and high glycemic index portion control like in a no no I I'll take the back if you're a normal huh okay if A1C is normal then then okay okay I'm saying only in diabetics P diabetes control control M mango jack fruit and B yeah no many dog

CH uh chiku chiku custard apple why do they say maala then you know that's a very common thing in Tamil they say Malala which is mango uh banana and uh jack fruit because most commonly consum umed there m and custard apple actually was cons it's a wild it was actually never to be sold I see custard apple used to grow like weed in the wild okay later on somebody found out that this works but it is very sweet so a lot of people like I uh in my childhood used to like it because there was

huge entertainment Apple out of eating a little and spitting the seed out like time pass we used to do they do juice as well right they do juice as well very sweet sweet juice so that is one of the things that is there but that that I don't safal that they call in right so it was supposed to be a wild fruit then we figured out that it was but yeah if CH is very high chiku or sapota whatever you call it so so I say one fruit per each meal and then I say one

fermented food per day has listening to you what is your accounting mechanism with your GI dietitian actually I should ask her it'll be a wonderful chat with her some learnings will be there so accountable mechanism is uh that um see my consultation takes an hour uh that's why I don't see that many patients I see I know it's Revenue Wise It's not a big it's not a good thing the more patience you see the more every but yeah but I say very less patience so the first thing I do is to make them understand why

am I doing this and as you know you must have listened to the podcast where we talked about 100 trillion gut bacteria there is something called inter Cellular Connections MH inter Cellular Connections follow me here it's a little bit scientific where all the intestines all lined by cells these cells are closely tight we call it as jam-pack Junction tight cells mhm and there is no opening or Gap in between at all and these are all innovated by something called myric plexus uhhuh my ENT my is my ENT is interestin my ENT and my intine personal

to you personal very important very important bio individual basically you have your own neurons applying your own inter separately got it very important that myric plexus gets connected to brain ah okay got it let's say there is no brain contion this will still work this will still work because of the local chemicals being separated being produced by the good bacteria so that's how strong it is people say that your gut is a second brain I have changed that now your gut is a first brain first brain because it is primitive it can work even then

correct so when that is so [Music] powerful again um follow me here slowly we will break it down if it is difficult the the bacteria along the lining keeps on watching mhm okay the the immune cells and the lining of the good good BAC keeps on watching what is coming in what is go coming out gram negative bacteria gram negative bacteria is something that you don't want inside your blood mhm it's a gut bacteria okay what happens is due to all the lifestyle factors we talked about mainly UPF Ultra process foot that's why I always

say when you're tearing a packet you're tearing a piece of your gut the reason is you're piecing piece of a gut is exactly in between these two cells so there is a gap in the connection so while there is a gap in the connection there is a delayed connection and similar to what we talked about that is where the starting of the delayed signal with slow G motility happens so when that there's a gap this gram negative bacteria is very happy that there is a break in the barrier and then that is that leaky gut

they licky gut ah licky gut is very controversial I know people say there's nothing like this there nothing like that but this is the pathophysiology behind that okay so how do we know right we talk about all this how do I know that this is what is happening when you take the blood of all these people you see something called LPS lipopolysaccharides when get the blood there's increased amounts of LPS and where is this LPS coming from is the outer membrane of this gr negative bacteria oh gr negative wow so when the LPS is very

high it's an endotoxin so we call it as metabolic because of the metabolic eating thing Endo within the blood inside toxemia metabolic endotoxemia okay so now what happens there is a toxin in the blood H what does body do in inflammation inflamation all your TN of alpha il2 il6 everything is trying to attack attack this toxin correct and they are very successful in attacking the toxin then what happens to this inflammatory cyto they are thinking that oh there is some more is coming in so let's just stay there H so what happen they're staying there

so the endotoxins are not coming in affecting the cells correct but same way because they staying there all the hormones especially in insulin it is also not able to get into the muscle cells got it so then the muscle is very starving of insulin muscles send signal to the brain and brain is saying that I need glucose I'm not getting it correct brain send signal to the pancreas yeah produce more more insulin yeah got it yeah and that is why when you check the blood you have more insulin levels and this is a this is

not the usual pathophysiology but this is a separate kind of a no but this is the UPF PA this this is the this is what is happening ah this this is the bot line Bottom Line This Is It even before insulin is being that is what you're saying people talk about insulin resistance people talk that is not important this is not important so behind even that this is the process basically got it got it that's what you said you largely stop the ultra processed food first no to heal the Gap first to huh so there's

no more this metabolic endotoxic so stop the ultra but what are we doing we are giving more insulin when you get because the glucose level is high what we do we get more insul in inject yeah when the person H worst thing I mean we cannot do anything we have to do but what does does temporary life saving but doesn't resolve the but but the muscles is still staring yeah yeah yeah yeah so when you go deep into it right I have a beautiful algorithm and a picture with an animation I have a muruk packet

right in my house and in my office and then you'll say this I ask them to eat it no seriously I'm not kidding I'm not joking I asked them to eat it I'll ask them okay you ate the muru packet you tell me what is happening he will say okay it is going into my fot pipe into my stomach okay how is it going from the stomach in a small intestine digestion acid doctor yeah then that is a animation so I show them acid and by the time they see this Gap in that function and

they could relate every everything down so if you later your heart disease your diabetes your obesity your hypertension your PCS everything will boil down to this little thing that is happening over here and this then kick starts the metabolic syndrome process does this metabolic Endo exactly Cardiology is talking about heart attack Endocrinology is talking about diabetes gastro talking about I learned something but everything is tied down to this small little thing because of your UPF Ultra process is the main thing then there could be other thing mlc p50 P10 or something um I forgot but

all those additional artificial flavors natur everything colorings and all of that so if you eat one packet of chips will that cost fine yeah yeah yeah it is it will take 2 to three years yeah no I've told this to everybody it's not like today you'll do something and the body will react tomorrow it's very forgiving that way body superbly forgiving so I say that it will tell you 2 years 5 years it will come but the recover is also the same same yeah B depending upon the amount of effort that put correct correct so

so once I say that then I say to look at this guys the only doctor that you need is me you don't need anybody else we'll fix this Gap yeah uh and you will be okay right so then they'll be eating the muru they'll keep the muru they remember this visualize that no while eating that is hilarious I think I should also open a physical clinic and try all these techniques tell that is very very very powerful and have a lot of animation and I have I have a model GI model lovely it's like a

projection model yeah I understood so they can actually see instead of just we are talking and I all I have all the evidence as well so they some educated people of course they w't thing I'll show them look at this metabolic endotoxemia LPS is there right here and look at all those things so this is the bottom line so metabolic endotox toxemia toxemia I'm going to research toxia yeah please please do so then what happens is that that is why so then they ask me okay so I stop the UPF everything will be done no

no you need good get bacteria to develop Beauty rate to seal the Gap beate yeah and that is why the fermented food is absolutely critical correct correct and they will say how long I should take I said 2 three years every day yes every day which food depending upon your local ethnicity correct correct if you're Punjabi kanji everybody has it orisa uita yeah Kerala aam Tamil Nadu do are Italy yeah is alsoas Assam Kisa you know what Kisa I've heard it from you only on your other broadcast I haven't tried it yet fermented B Sho

ah Manipur there is haai jar so India is one of a wonderful country where there are that's what there are versions of all of this in our own Regal Cuisine so I say always one fermented food per day one fruit per meal and uh of course fasting we talked about I have a doubt doctor do you really think like a like a dla is comparable to a parur um I I always thought that the power in the fermentation process of the the parur or or k leftover rice which is and then you add butter milk

and then whatever that profile just like how dla may not be the same as kimchi or saak right see the answer is I don't know nobody knows nobody knows because I have my doubt if it's the same but I'm sure both are helpful I I'll tell you nobody can find out the only person who can find out is you because it is it is individualized right right can be good for me but not for you yeah so how do we know so when you introduce fermented food you cannot introduce multiple things at the same time

correct correct you have to introduce one thing and then see whether you are seeing any Improvement in your sure sure so b m is one of the most important the most important ritual in the morning is not meditation or anything but is to have a proper if you are sitting in a toilet ball for more than 5 minutes yeah without anything happening nothing is going to happen get out we are doing poop jokes now from a gast I'm telling you get out it's not good for you it's not good for you yeah so that's one

thing uh and then we people always know good don't do the stool testing uh just look at your stool measure I mean consistency and everything yeah uh the more effort that you put in uh to get the stool out the more effort that you'll be seeing the doctors yeah yeah yeah so diet is that's why they say food is medicine correct is medicine correct so um that is why I focused on gut bacteria everywhere I go I talk about gut yeah um I always have a famous saying inil just correct correct so so I have

a strong feeling I also talked in an Endocrinology conference people were like what are he's talking about I said if somebody does this for 2 to three years all endocrinologists will be out of practice all IVF CMS will be closed and all cardiologist will have a better quality of life yeah true they don't have to come with the middle of the night it takes time it takes patience it needs to understand the pathophysiology behind it yeah but I think one of the best things that you have done and I have really not heard this from

mainstream doctors really you have knowing very well your limitations as a medical professional and a gastroenterologist you have taken the effort to set up a team H because doc this what you're telling you need another team to constantly follow up and you know I don't see a lot of mainstream cardiologist for imagine if every endocrinologist or every cardiologist or at least the the the ones who have resources had their own team yes maybe one researcher and one one like you have a GI dietitian one has a diabetes educator that story that is what we need

that is what the you I am the doctor is e even if they are like you and be generous and not care about revenue and all of that great and spend one hour the skill required to do the other part looking at diet plan sending diet plans doing followups uh addressing uh patient queries or troubleshooting this is not your job has to be somebody else who does it that we don't have time you don't have time and you that is not what you're supposed to that is where dietitians counselors dieticians who can become lifestyle counselors

that comes and that is such a see you know what happens I'll tell you good doctor friends of mine from Twitter will refer me okay unfortunately the value of a dietician who is able to understand metabolic diseases people don't have that value the minimum I say hey you know let's say I'm charging 500 rupees for a consultation they're like I don't want to talk to her what is she going to give me they don't even come back they don't come back doctors are nice the neurologists cardiologists refer on Twitter they'll send me a message they

say we referred a client the client the the P we refer a patient the patient will say hi so and so doctor refer you I say yeah this is the consultation process I need the reason I also look at consultation is I need to spend one hour with you yeah yeah of course your family history your food history your bowel M history your everything right but they are like I have to eat food they're not understanding where it's going so I feel imagine if this setup was there was this entire setup like what you have

done no it's it's not I have done it's just that Gastrology let's say any book at the end of treatment for any disease is multidisiplinary management but so is so are most non-communicable diseases doctor I'm just so I mean yeah yeah of course don't you think so of course of course I mean now NCD is happening because of Gastrology huh because you're putting unnecessary things into your stomach exactly NCD should not be NCD at all it should be gut non-communicable diseases so in Gastrology it's multidisiplinary Management in an academic center you have a gastro you

have a nutritionist you have a psychologist you have a cognitive behavi therapist you have a um Advanced endoscopy people gentle G people motility can you imagine there is a doctor who just into the stomach alone motility alone so body is complex yeah and people are fighting vegetarian is better nonvegetarian right there's more most useless fight on the there more to it and uh it is just that um you absolutely right multi-disciplinary management is the way to go uh and I think it's slowly catching up yeah slowly catching up I'm so glad that you're having so

much knowledge to I don't think even my G I mean my G know but other D will not be able to handle this convers thank you doctor I'm not bragging myself but I'm just saying that it takes a lot your your level this is what I do right I try stud this I tried this yeah but my experience doc obviously I told you I self-learned then I certified myself and I get a lot of um Flack that I'm a six months nutrition person versus a ad I'm saying the more important thing is to learn can

learn from anywhere every day we learning you're learning every day every day second is what experience on the job gives you with then like I said the reason I don't have time to probably do Instagram not my primary is every day I spend 1 and a half hour in an area of my interest today it could be gut that gut is never ending because I'm really telling you I every alternate person comes to me on some spectrum of IBD it's IBS or constipation or heartburn or so I cannot ignore that and that is really emerging

second is like I personal interest is to look at supplementation that is just no so the thing is it is the variety of work that you do with the number of people with when they present to you with with certain conditions and then you start looking at the literature then you start looking at certain case studies that have been probably not in India elsewhere then you change that and you adapt that then you play it safe and see so corre that that is how I have come this far really of course and then and patient

experience also matters the more patients you see you will be able to see you see a different profile of course of course I I'm actually in a better State because even though I practice in US my practice has been changed to Indian Community so I have this wonderful mix of just nris alone yeah nris non-resident Indian Community is my patient so everybody has the same problem and everybody has the same background so I'm able to see as soon as and it's beautiful to you can draw so many patterns so many patterns many patterns and that

makes solution providing slightly faster right as soon as the patient walks in I know okay so this patient needs mental health thing this patient in G so so you're absolutely right I think multidisiplinary management is the way to go bottom line for everything is the discussion started because the 25 G of fiber that I am adding and then one fruit per day per meal and one fermentation per day all this is boiling down to sealing this Gap preventing the translocation to decrease the toxin decrease inflammation get the inflammation out get the insulin work again this

is the pathway and this pathway takes time correct correct can't be overnight noon can be overnight can be overnight we talked about the belly fat yes but the reason for visceral fat for Indian people is that our abdominal compartment is smaller the fat gets accumulated Ben the skin it's called subcutanous tissue subcutanous fat this amount of fat that a Indian person can hold in that compartment is very small I I I've also read and researched a second aspect that the size of our fat cells in South Asians and and in Indians is also smaller I

see I don't know so when I follow Professor Ben bikman's work who does a lot on uh insulin and fat tissues a scientist metabolic scientist so there are two ways the second aspect is South Asian communities Malaysians Filipinos Indians okay the the number of fat cells we have is fewer than our Concan counterpart and the ab of our fat cells to hypertrophy which is expand is also limited you would okay which is again uh not the problem in our Caucasian brothers and sisters which is probably what you're saying combined with this is the West in

America they can be 20 kgs overweight and not yet developed diabetes uh and in India you can be 3 kgs and 5 kgs and develop just that PO belly and have lean arms and legs and have elevated hba1c levels and I think this concept is described as it's called the personal fat threshold yeah that's a very interesting concept so not only is our capacity to store sub subcutaneous fat less the ability for us to expand our fat cells and become therefore insulin resistant and spill over is it happens quicker it's quicker the the you what

you might be saying might be true true because the fat cells not expanding the fat cells are small and everything might be true because I know that there is a hormone called adiponectin yes adonet is a hormone secreted by these fat cells correct Adon is good for us because whenever there is more fat it regulates it increases a transmembrane fatty reg fatty reflex and make sure that the cholesterol levels are the same level but Indians have a lower adiponectin level compared to other ethnicity that's because the number of fat cells see the riverse I can

tell you and therefore uh the expansion is also whatever correct so coming back to the point we discussed that you know we already have increased of belly fat corre more carbs uh and also you mentioned about uh you know other fat incre calories the baby C calories where is it going to go belly fat correct so again the bottom line with all this discussion is uh I think moderation has to play a role significantly in all aspects no fair enough absolutely I don't think there is a need to emulate any particular Trend just because it's

a trend H so now I'm going to I'm going to complete this discussion let's complete no no I'm just saying compl the disc this this this segment by promoting plan forward diet sure okay I'll put in my argument so you remember I told you about this gut cells thing yes okay so this gut cells ceiling of the gut cells will need fiber and you and me know that me doesn't have fiber the our counter argument to the meain people is that that is a good source of protein so we already protein deficient so why are

we avoiding meat of course you eat meat it's a good source of protein so my plan forward diet is approach is you I don't care about the protein that much as long as your gut is good so yes protein is important as well but the priority according to me will be second as long as your gut uh health is good because I have strong feeling that the hormones will make sure that your appetite is controlled in such a way that you will get the protein by taking mindful decisions that is my argument so uh to

get that Junction sealed you need more fiber so my argument is I always go by I call it as Dr palarian diet where it is not vegetarian non vegetarian it is a Dr palarian where you take 80% is plant H the reason being is that hoping that with 80 % you'll get your 25 G of fiber the remaining 20% I really don't mind you eat red meat it's okay yeah it's not going to cost that much amount if you really limit yourself to the remaining 20% that is what my argument is so um doctor you're

I understand where you're coming from now as a nutritionist people come to me with various objectives Okay and like you rightly said my current challenge actually if you see there is a protein Challenge and there is a fiber challenge these two challenges coexist okay now for me the fiber challenge is easy to do because there is a fair amount of acceptance let's look at how the practically practically how it works right so nobody there is only one part of the thing who's saying plants are trying to kill you no majority of the people like 9.99%

of discerning people know that there may be some plants they can't tolerate but in general vegetables and fruits are good for you for me to address the fiber problem so that your your objective or common objective as Healthcare professionals that the gut should be protected protect your gut okay feed your gut protect your gut that is easier for me to do because no there are no misconceptions there there is agreement there there is accept there for the past 100 years you have heard eat more fruits and vegetables eat more fruits and vegetables eat more fruit

so the challenge is how do I just make it convenient and give ideas to people and keep reminding them you're not like what you do with plant protein and fiber points uh sorry plant points I say like I all I have to say is get more get more get more the protein discussion is a bit of a different discussion because let me tell you the other side of people who come to me large amount of misconception or what is quality protein just go to YouTube and type protein deficiency in India you will get at least

50 videos that say that the primary home uh maker at the wife the mother they don't even understand the concept of protein okay number three lack of quality protein and animal protein causing massive levels of anemia stunting yes of when we talk about public health protein energy Mal nutrition yes next if you look at uh it uh the the biggest complaint 40 plus year olds whether men or women come to me uh is um is uh it's called um undiagnosed fatigue uh psychosomatic joint pains okay it's not psychosomatic there is okay so joint pain fatigue

not being able to get up and even walk 20 I kid you not okay uh muscle decline okay being overweight and not consuming enough protein uh largely falling over CBS This is not a fiber problem this is eating cbbs okay and gaining weight and Ultra processed food then um doctors giving them six months time to say lose 10 Kil kgs else KN replacement for me therefore these two things become very important because now we know that if there is no adequate protein there is sarcopenia there is bone density loss um the the greatest uh I

think the greatest yes the the the mortality in older people is once they fall they're unable to get up uh hip fractures one of main things exactly we how many times in India I have heard my grandfather fell in the bathroom and that was it he never recovered from that fall women mainly women right so all of this and then let me give you one more very important reason we spoke about Indian indan population having a smaller abdominal cap capacity and the personal fat threshold level let me tell you one more thing in Indian population

compared to many other ethnicities we have lower muscle mass documented um by birth it's a genetic phenotype we have there are many theories around it the theory is that uh one we were around tropical areas so we grew agriculture produce then we grew in population so our our food became more agriculture based there is one Theory by Dr manoshi batara I wish you interview her I'm happy to do the uh introductions very well-known doctor and a food historian and researcher so her um her um uh hypothesis which has been validated many times 300 years of

colonial rule 5 to seven famines shifted and the taxing of uh of the common people uh by the Raj rule they took away meat they took away livestock gave back grain all the famine led us to holding which over a period of probably Thousand Years including the Raj and therefore how our diets develop to become very mushy Keri everything is mushy because cheaper large amount of calories can be consumed easily because we don't know when our next calorie are coming because of this history of five famines so Indians have a lower muscle mass now double

mamy easier cap is it because because we have lower muscle mass our visceral fat high so all the other way all the other way now we can't do anything about our adpost tissue but we can do something about our muscle mass right the number one thing we do is give adequate protein so that you can at least maintain it and not continuously lose it with the lack of protein second you can control your calories and follow up ration carbohydrate diet and all of that and don't gain waste circumference third thing if you're open and if

you do strength training like you've done the 100 day gut man challenge because I I've seen your podcast you lost weight but you realized your body muscle mass great completely gone you were I preserve it iock you did not preserve it because probably the protein your focus was on many things and given the fact that we come from this ethnicity we are probably losing muscle mass at a greater rate so this is my reason to focus on protein in a heavier manner for longevity for muscle Health uh for better glucose disposal at the same time

handle the easier challenge of eat eat Dal eat eat eat fiber so let me ask you this balance it I got wonderful the gist wonderful discussion let's say I'm a patient to you okay and I am I'm we're not talking about vegetarian I'm I'm I'm open to options yeah what percentage that you say that I should be non Wich I will give you all all the range and I say rotate it that's what I do okay now let's say you're a uh you're a meat eater who eats everything yes fish okay I will tell you

there are 21 meals in a week rotate everything eggs Greek yogurt paneer chicken fish red meat rotate now 7 S7 okay now use your uh lentils and legumes as great sources of complex carbohydrate and fiber so I've added then add in a little more fiber which is above the root fruits and vegetables you're very healthy no other problem start alternating between uh grain potato sweet potato alternate as good carb sources with all of this if you train now add another 150 gr of fruits Dairy here and there Cur I think that is a decent approach

to take so I never say I may personally prefer eat a lot of animal Source protein but you also take that extra step to make sure your fiber is okay I do that and I have there is never a meal without fermented food on my plate I see next time I'll start posting if you follow me on Instagram so that I show you but I post on Twitter there is Sauer craft there is kimchi I make at home there are pickled vegetables there is Greek yogurt every day there uh there will be some Sal cucumber

I do not do only when I'm in a hurry you will ever find just meat and some maybe some Shira sauce but even then after that I'm eating Greek yogurt and one something so we so this is my Approach we were discussing to both protein and so if you're somebody who is uh open to everything the best way to rotate your protein get the best of the Both Worlds use plant protein as great fiber sources and for all the other micronutrients that it brings in use vegetables again for antioxidants and things like that and your

nutrition is complete super uh I'm realizing the more I you know speak to you and speak to everybody else there's no one size fits all for absolutely not do so my 8020 role will work greatly in a mass community health education where many people think that oh 80% p is plan-based maybe at least I should include more plan points so you'll get the fiber okay 20% meat is okay then maybe get the protein somewh but I completely agree with you that if that particular patient is protein deficient or like losing muscle mass it should be

animal forward yeah so great great Insight that when you are educating masses you need them to finish ABCD first first okay I'm not saying that the masses ABCD is not protein but at least it is to include a large amount of plant food which is more accessible once they finish their a b c d e then we can go to words and say now okay include because let me get at the ground of this when you talk about Mass public health awareness at a personal level I I'm looking at one person you are probably talking

to 35,000 people at a go corre correct for me it is one person so my resolve is as for that person I on to one-on-one consult and as a content creator also I talk bio individuality which is what is good for you now let's shift this little bit to saying that to uh to address the accessibility and affordability of animal protein I alone you alone can't do it the entire yeah because protein is the most expensive component of the macronutrients fiber even a tier three person we we struggle with buying vegetables in in urban India

their only bindii is 110 kilos in rural in tier one tier 2 vegetables are actually cheaper even lentils are probably cheaper there is probably still a kirana system there there is probably mom and pop stores there where you get credit there in some Russian uh PDS public distribution system Dal is available okay now imagine if I from a mass level have to tell people get your protein get your protein in a sensitive culture like India where the cheapest form of protein has been banned beef is the cheapest form in IND let's think let's think in

that the cheapest form cheapest it's 400 rupees a kg so compared to chicken beef is cheapest uh almost almost for the nutrition and and the and the liability from certain communities almost there almost there okay now if I have to if if at a mass level which you do which I don't do if if I would tell which is a question everybody ask me even on Twitter people don't have they can't Dal and rice is is becoming a problem they're not including enough plant points more ultr processed food is penetrating into tier 2 tier three

cities how will people afford protein because protein is the most expensive macronutrient now that is something needs to be done at a policy level level policy level which starts within Municipal schools don't have agendas let children have eggs and at least chicken what is happening no eggs in school depending upon in Tamil Nadu they eggs in school it depends upon which party is ruling the state is that right so certain States they don't have eggs in the school in the if there is a lot of right-wing uh is it right I didn't know that then

that is going to be pretty deficient to start with exactly so so uh you know don't bring in your your religious based values nutritionists devoid of these values right you better provide good vegetarian sa of protein then give paner paner please let there be a a dairy whatever uh to whatever not at least children why is that not happening expensive pan is expensive Dairy protein is expensive paner is even more expensive by Gram and per protein than egg wow wow and if you have to do it at the ah that cannot be done so so

I think a whole food plant forward with some animal based food works for public health messaging to elevate the awareness and the consciousness of people but then when you come to individuals like me for personalized Health then it is up it is up to what you need to do or in general when I talk about protein it's like don't have misconceptions if you can afford it I talk to the affordable largely people who afford it there's a different so I said you people at least don't have uh misconceptions around protein how much you need and

and do it and I also do a lot of content on Twitter as to how you can cheaply get it like everything doesn't have to be mutton means chicken is cheaper yes uh organ meat is cheaper if if you can handle it so what is organ meat basically we have mus the liver the liver Li spleen spleen you have B intestine um from where from cow or no don't even talk about cow please usually it is beef Buffalo or this is like self stabbing yeah yeah no please I have I have been abused enough on

Twitter for putting by mistake I went to Kerala and put some beef picture I see they've called me all sorts of demon names in the Hindu mythology so I'm saying it comes from mutton largely you will be surprised how much organ meat culture is there in all three states down so Tamil Nadu and uh this one Kerala call it talari yes You' heard of it talaki yes in South we in in Telangana in the Rima side they call it talaki that's a head of head of a goat goat then you have val tail tail okay

uh so TOA pulusu TOA pulusu in in Telugu is TOA is tail pulusu is liquid so cultures so again I talk a little bit of organ meat because the people who don't have a lot of resources financially their nutrition gets complete by inclusion of organ meat twice or Thrice in a week because they are powerhouses of micronutrients they don't go and test for zinc and and and vitamin B12 so I think then this this Nuance somewhere is so interesting to I completely get your point when I say when I talk to large populations I want

to be plant forward because that's healthier 100% true because otherwise 80% of population is eating chips and biscuits so please come to DAL and vegetables right of course I completely get that of course and there's also one more study and we'll wrap it up after this where the reason I keep on talking about the junction is once the junction is tight the brain G axis gets activated this Gap you're saying this Gap is closed the Gap lining the intestine it's because of your UPF your high CS emulsifiers allpurpose flower all all purpose is one of

the main thing as well they call All Purpose FL over there so that increases a gap let's say we remove all this and then we give more fiber for we fix this the brain gut axis gets stronger when it gets stronger the connection of the gut over the decision- making capacity of your appetite stimulation Center gets stronger H what I mean by that is it's philosophical okay no no it you will have the energy and you'll be more productive enough to at least I mean in in in a population I can talk you will not

be fatigued that much that you'll have the energy to understand what you need and what you don't need and you will start choosing foods that you need now what is happening is you're already fatigued you don't have the energy to think about what is healthy food what is unhealthy food all you're thinking about is I'm hungry I delad what want and how do I know that this brain gut connection is very stronger is based on the neurochemical that is being secreted by the gut bacteria H which is being secreted of the same chemical at the

hypothalamus on the NTS level wow it is absolutely mind amazing and this is we know very little right very little we are just stipp of the iceberg exactly this is just we are coming to know uh very little uh yeah it's it's fascinating it's fascinating absolutely the a patient eating pizza has more dopamine level at the intestinal bacteria which is creating the connection to the brain to secrete more dopamine at the brain level to order more pizza yeah right the same thing can be repeated with dull or with uh neuroplasticity with broccoli or something whatever

you want but it takes 3 months it takes 3 months because would you say that the pizza takes faster because of the hyper poolability yes because you cve more you C more let's say that is why when the need for me to eat healthy can have may take 3 to six months if I start introducing healthy food but the need for you to order pizza can happen within a week correct with good habits take time yeah within 4 to 6 weeks nothing comes easy that is why when a kid is saying that I don't want

broccoli I'm not eating all this reinforce it it will take time but it will come and once it's stronger it forms strong it almost behaves like second skin which is what we all do after our own experience and by repeatedly choosing the right food you almost build your gut in such a way so so the like I can't doc I'm not saying this like it's not a lie every time I eat a pizza and people people may say what a sensitive gut it's not sensitive it is some regret I have because something doesn't feel right

of course of course you don't have the gut back to digest that's exactly happen and then I I'll keep whining and whining and say what stomach feels weird stomach feels okay let me fast 24 hours ultimately that will be the answer my wife exactly the same thing she cannot eat Pani Buri P because she's just so clean yeah and gut that you know she for me the same thing happened when I was fasting I ate everything so you you allow little bit of I little bit of toxic everything maybe that's a good idea little bit

some there you should I'm very good in potion control I call with the potion but in the fasting overnight one day I went to the hospital on call and I was so good my 9:30 to 7:30 I've been doing it for four five years all right one day emergency call I forgot to eat the dinner with protein fiber something happened I ate some DOA something I didn't I was hungry at 1:00 a.m. in the night in the night because I went to the hospital to do an emergency procedure 1:00 a.m. I went to the doctor's

Lounge I ate a bread with the it's not unhealthy it is peanut butter ah okay peanut butter could be not bad at all I didn't eat chips chips was there as I didn't eat chips I did the procedure on the way to the house I threw up yeah I threw up and I realized that okay so my body is so adjusted yeah but there is a different school of thought which my friends taunt me says you go out for a 10day trip and you have to eat some ugly food looks like you're going to have

a problem I said probably yes is that a possibility yes it is a possibility right but but you will you'll keep eating that you don't have a choice so you'll keep eating that your get bacteria will come back for the bad ones so now when I talked about the emotional control of the appetite center it's exactly what I'm talking about that cra will come down you keep on mentioning the hyper palatable foots remember the junction got widened because of the ultra proc and why are you eating it because your brain is asking you to eat

it corre even you're going One Step Beyond if you control the brain yeah you will not eat the UPF yeah now I have figured out when I travel even if I don't get like good restaurants and all if I'm at daas I know CD nuts 10 things I'll carry I can't go wrong with an idly not bad at all all I won't go wrong with maybe some CD okay so I have made my piece with all of this even Dal rice is okay that's also okay I will not do like very gravy item that is

my downfall gravy gravy outside I don't think I'll have a better guess than you to explain everything what I did right now so I'll just put a summary for everything no no let's wrap up okay so that no so that you will understand what I'm talking about yes absolutely doc so we'll go backtracking okay we'll go back tracking and we will find the action points action point one action point and then we we talked so much that for this episode right AB what yes no no not not for this episode I'm just asking I'm telling

about the formation of NCD non-communicable diseases right I'm going to go one by one okay right done so choose a non-communicable disease uh diabetes diabetes okay everybody so we have diabetes yes okay diabetes is what is happening because insulin is not working properly yes and we talked about there are so much insulin yes but insulin is not working yes why it is not working because it is not getting into the muscle The receptors are insensitive are insensitive okay why is it not getting into the muscle because that receptors are being blocked by this inflammation correct

where is this inflammation where is it started it's because of the endotoxins that is in the blood correct how did that happen how did that happen because of the LPS lipopolysaccharides of the membrane of the gr negative bacteria gut bacteria from there how did the gut bacteria came into the blood intestines leaked into the blood right how do the intestines Le to the blood interestin is supposed to be very strong there is a small Gap correct why did that Gap happen why didn't why did the why did the Gap widen because of the ultra processed

food maida and everything why did you eat UPF and maida to start with because your brain wanted the Cravings to stimulate right why is the brain craving because your brain G taxis is not working so then what is the final answer your gut yeah thank you so much that is a rap folks exactly that's a rap folks that's a rap it all starts with what you're putting in your mouth because that is where it ultimately goes and everything triggers from there exactly so don't look for shortterm solutions for anything eat healthy be plant forward or

animal inclusive be animal inclusive or PL forward important is that you understand nutrition okay great beautiful thank you so much was wonderful thank you Dr I've had such an awesome time and it's great I could bounce a lot of my pushback on red meat and and we could really have this conversation sometimes it's very difficult to ask questions right very healthy disc very healthy discretion I think the bottom line is any nutrition advice coming out is not one siiz fit all 100% you need to see where is that person coming to which Community is being

addressed yeah and whether you belong to that community and that's a human being you are not designing a diet for 30 people for the sake of in a metabolic Ward for the sake of research that diet outcome will be very different when I'm talking to a real Sita or a real Dr pal in the real world with a lot of real challenges real issues real what is in their gut outside their gut right so yes it just cannot be a one siiz fit all emotional motivations behavioral patterns all of it matter all of it matters

all of it matters all of it matters so what is the final take on this final take is I'm going to end my fast dog it has been 3 hours and and go and satisfy my gut by eating some grilled chicken and satisfy um the reason for me to be here by including a massive portion of broccoli along with yes of course my fasting is done fiber I will do what is the third oh fermentation one CD also I'll have exactly so that you'll have good gut feeling yes welcome to feeling with Dr thank you

amazing super that was a wonderful episode I learned a lot I'm sure you learned a lot as well I really want you to make sure that the discussion that we had if at all there some points that you have noted I really want you to take some time understand what those points are see whether that is applicable to your life and if it is please write down in the comment section in terms of what you learned as usual so that that gets registers in the mind the more you put writing and uh writing in words

that thought process gets registered a lot more and there are multiple resarch to prove that as well so I'm hoping that the techniques that we discussed will be implemented in your daily lifestyle as well thank you so much for all your support the whole goal is to make this podcast a real Health podcast with credible information coming out so that you can pick and choose your lifestyle based on the recommendation that is discussed we have two new YouTube channels gut feeling with Dr pal shots and gut feeling with Dr pal Clips these are all shorter

versions of the hourong podcast episodes to highlight the salian Futures these are all 8 to 10 minute long or sometimes 1 minute long for the real please consider subscribing being an extend your support we'll make sure that we'll provide the high quality content to you by giving you a wide variety of input from multiple medical experts in case if you want to listen this in audio format while you're commuting or while you're driving please check us out in Spotify with the name gut feeling with Dr pal and please consider extending your support by subscribing to

that channel as well as usual it is one belly at a time it is absolutely important I'll see you in the next video bye