Case Study A 45-year-old woman came to see me in the clinic for difficulty losing weight. She has been on a low carb, ketogenic diet for 6 months but has lost very little weight and feels tired and sluggish. She thinks she has a prolonged case of the “keto flu.” She consumes between 30-50 grams of carbohydrate daily, but on further questioning I discovered that her primary vice was alcohol. She was thrilled to discover that alcohol is “low carb” and started making what she calls “keto cocktails” this past summer and has continued to have 1-2 of these drinks almost daily. I reviewed her labs and found that her liver function results were mildly elevated, her triglycerides had jumped up 20 points, and her body weight has been the same over the past year. Why Alcohol is “Anti-Keto” and Inhibits Fat-burning Ok people, it’s time for me to throw the…
Read MoreWhy Muscle Really Matters
Background I consider the preservation and enhancement of muscular strength to be one of the most important goals a human being should set at any stage of life. Lack of adequate muscle mass and function is one of the single greatest contributors to poor quality of life and accelerated aging. This study in particular is mind blowing since it is powerful evidence that strength training can actually turn back time and make you younger. The study looked at nearly 600 different age-related genes that control energy production from the mitochondria (our cell’s power generators), and muscle weakness.associated with aging. After older study participants underwent 6 months of resistance training, their genes markedly reverted back to a considerably younger profile. Resistance training genetically turned back the physiological hands of time…a veritable fountain of youth! Now think of how all of us age. We start off as children who walk, run and…
Read MoreUsing Your Phone and Heart Rate to Monitor Stress
Why Stress Matters It’s common to ignore stress since it is such a subjective measure compared to other familiar risk markers like blood pressure and cholesterol. Many of you reading this blog may already have a regular stress-reducing practice like meditation in place, but today’s post is for those of us who might keep pushing stress reduction aside. Most of us know what acute or severe stress feels like, like during an emergency or emotional crisis. However, many of us are living in a constant state of low-grade simmering stress that has become an unrecognized state of normalcy. Let me warn you that there is absolutely nothing normal about this. I’m overwhelmed now in my clinic and during wellness programs by how much disease (heart disease, cancer, autoimmune conditions, etc.) is triggered by stress. Read this post for more on how isolated stress without other risks is triggering disease in so…
Read More7 Numbers I Track for Weight Loss
Weight Loss Case Study I saw a patient a few weeks ago for weight loss and diabetes reversal who told me he was on the keto diet, had lost 10 pounds initially and then plateaued. His diabetes A1C blood test dropped from 10.6 to 9.5, but without further changes. I asked him how many grams of carbohydrate he was consuming and he told me he wasn’t sure, so I did a detailed dietary intake and estimated that he was eating on average 250-300 grams of net carbs (grams of carbs minus grams of fiber) daily. Although this was much better than the 500+ grams of carbs he was eating before, which is not unusual for many of my Indian and East Asian patients who consume large portions of breads, rice and other grains, it was far higher than the threshold for nutritional ketosis, which is typically 50 grams or less…
Read MoreWatch My Google Talk on Curing Diabetes In Diverse Cultures Without Drugs
Watch My Google Talk on Curing Diabetes in Diverse Cultures It’s almost the end of November, which is National Diabetes awareness month here in the US. My talk at Google on curing diabetes in diverse cultures just went live. Many of my followers who have attended my prior talks have called this the best, most informative talk yet. Please watch the talk below and share with others who you think can benefit. I don’t just talk about diabetes, but also focus on weight loss, especially the challenges in women, fatty liver, high triglycerides and more. In addition, my wife, pediatrician Dr.Shally Sinha, joins me at the end for the Q&A session to answer some great questions on children’s health. The talk is also a good introduction to my body of work which is further supported by my book, my online program and other resources. Finally, join me and my phenomenal…
Read MoreThe Real Risks of Exercising Too Hard and How to Exercise-Part 1 of 2
Background This is the first of a 2-part series on exercise and how to do it in a way that maximizes fitness and enjoyment without increasing health risk and injury. I feel there’s been a shift over the years where many of my existing and new patients are now engaging in different types of exercise. There are so many different options out there as people are becoming more health conscious. Now that’s the good news. The bad news is when I watch most individuals exercising in the gym, or evaluate the types of exercise regimens my patients are participating in, I realize that they are unsafely elevating their heart rates to excessive levels while moving their bodies in ways that make them prone to injury. In many cases I can already predict an impending injury like knee pain, plantar fasciitis, back pain, etc. which will negate any beneficial effects of…
Read MoreEliminating Pain and Improving Exercise and Athletic Performance-Part 2 of 2
Background If you haven’t read part one, please do so now, especially the part about anaerobic versus aerobic exercise. You need to understand the difference between anaerobic and aerobic exercise for many of my recommendations in this post to make sense. To very briefly summarize, anaerobic exercise occurs when you are forced to start breathing through your mouth and can no longer comfortably carry on a conversation while exercising. If you’re out of shape, even a brisk walk or climbing one flight of stairs can quickly put you into anaerobic. Now how is anaerobic exercise related to pain and performance? Excessive anaerobic exercise physiologically increases inflammation and the generation of damaging free radicals in the body. Anaerobic exercise also leads to a breakdown in exercise form. Just notice what happens to your running, cycling, or swimming form when you start breathing heavily through your mouth (a marker for anaerobic exercise). A breakdown…
Read MoreHow Back Pain Made Me Taller, Slimmer, and Faster
Background As a primary care physician I have treated a lot of patients with low back pain. The usual protocol was for me to examine the patient to make sure they don’t have a dangerous condition (herniated disk with nerve compromise, cancer, etc.), provide a handout with some stretches, and prescribe some painkillers as needed. If the pain didn’t subside, I’d refer the patient to physical therapy. Until about 12 weeks ago, I had never personally had a significant episode of low back pain. I’m fairly athletic and frankly lift and move heavy things without paying much attention to my posture or mechanics. In fact, I almost took pride in moving and assembling very heavy items normally considered a “2 or 3 man job” just because I could, despite the concerns of my wife….”You did what? Why couldn’t you get some help?” So roughly 3 months ago I decided we…
Read MoreExercising When You’re Upset Can Increase Heart Attack Risk
Background “I can’t believe the way my boss treated me at work today. I’m definitely going to catch my 6pm high intensity kick boxing class so I can take my anger towards him out on the punching bag!” Have you ever felt similar emotions about a situation and decided to channel your anger and frustration through intense exercise? Although for some people this may be an acceptable way to deal with anger, especially if it prevents you from getting into an altercation you might regret later, a recent study suggests that it may increase heart attack risk in others. An analysis of the INTERHEART study population which looks at heart disease risk factors across 52 countries and involving over 12,000 heart attack patients found the odds of having a heart attack were three times greater for those who had exercised and were upset or angry in the 60 minutes leading…
Read MoreA Key Method of Cellular “Detox” Wins the 2016 Nobel Prize
Background The words “detox” and “cleanse” are two of the most overused terms in the area of health and wellness today. They typically conjure up images of mud masks, spas and green juices that typically raise the skeptical eyebrows of scientists. However, this year’s Nobel Prize in medicine went to Yoshinori Ohsumi, a pioneering scientist who did groundbreaking work in the area of autophagy, a true physiological method for detoxification where your body’s cells recycle and remove their internal waste products. This cellular garbage collection and recycling service might sound like a mundane process, but having autophagy intact in our body is a central process for preventing disease and promoting longevity. We’ll explore the science briefly and then talk about which key lifestyle practices promote autophagy. What is Autophagy? Autophagy, based on its Greek origin, literally means “self-eating” (auto=self and phagy=eating). The biological process of autophagy occurs when cells ingest degraded…
Read MoreAre Your Batteries Low? It’s Time to Recharge with My Free E-book on Fatigue!
Get Your Energy Back! I was recently in the UK on sabbatical, working on my 2nd book when I received an e-mail from a patient that made me completely shift from writing my 2nd book to producing a free e-book. An excerpt is below and I did change a few specifics, to keep it anonymous, including the name at the end. Dear Dr. Sinha, I have diligently followed all of your lifestyle recommendations in the book and during our consult visit. My lab results are the best I’ve ever seen and I have lost 12 pounds, but I must confess that I continue to feel very tired. I have a very busy job as a software engineer with a daughter in high school and a son about to enter middle school. By the end of the day I hardly have the energy required to take care of meal prep…
Read MoreAn Exercise Our Asian and Indian Ancestors Used to Do That Burns Fat and Slows Down Aging
Origins of Squatting Squats originated in India and Asia, long before the age of furniture. Squatting made life easier as it gave people the freedom to “sit” wherever they choose; have dinner without a table and chairs, play dice in the street, read a book or take a coffee break. Aside from convenience, there are tremendous health benefits to squatting which I’ll review. I’ve also included a special squat video filmed and produced by my kids, followed by some other great squat resources to get you motivated. My book also has detailed illustrated instructions to teach people of all ages to squat, in addition to some of my favorite exercise Apps for further motivation. Why Everyone Should Squat More Often When I ask patients in my clinic what type of workouts they are doing, the word “squat” is rarely mentioned. I hear about walking (outdoors and on treadmills), ellipticals, using…
Read MoreWhere’s Your Body Fat? A Look at Body Shapes and Health Risks Across Different Ethnic Groups-Indians, Asians, Caucasians, etc.
Background The global obesity crisis has traditionally been focused on body weight and body mass index (aka BMI) rather than body shape and composition. Weight and BMI are blunt tools that can identify more obvious health risks, but unfortunately they miss the more subtle manifestations of dangerous and often hidden visceral adipose tissue (aka “VAT”). VAT, unlike subcutaneous adipose tissue (aka “SAT”), is actually quite hidden in particular ethnic groups like South Asians/Indians and East Asians. These are typically folks who come into our clinic looking quite slender with a normal or even low BMI, but metabolic testing typically reveals signs of hidden VAT such as high triglycerides, low HDL (good cholesterol), elevated liver function tests (sign of fatty liver), and elevated inflammatory markers like hsCRP (highly sensitive C-reactive protein). They typically have slender arms and legs and a slight to moderate protrusion in the belly region. Family members and…
Read MoreWatch My TEDx on Prescription Apps and Join Our Bay Area Meetup Group
My TEDx on Prescription Apps Sorry it took so long for me to post this. My first TEDx was a non-broadcast event (not online) back in 2013, in front of a bunch of execs and movers and shakers in the community, held at the Silicon Valley Capital Club in San Jose. This time around I had a different audience. Students and their parents at Monta Vista high school in Cupertino. I was particularly interested in this audience since they are in a critical stage of their life where career and health decisions can really set the foundation for their future. A significant number of them are pre-meds and I wanted to make sure they were in it for the right reasons. My topic for this particular talk was how I use Apps and media to engage my patients and leverage my message to a broader audience, like you guys. There were…
Read MoreA Must Watch Video
Globesity Crisis Below is a must watch YouTube video on the global obesity (aka “Globesity”) crisis. Four major obesity hot spots are covered: Mexico, China, Brazil and India. I encourage you to watch the entire video so you understand the dire economic and commercial forces fueling this health crisis, and also ask you to share with your family abroad who tend to be oblivious to this world they are living in. In case you wish to watch in segments, I included an index of the countries covered below in order. When you get to India at 37 min, be sure to pay attention to the information about how unhealthy pregnancies are literally programming babies for a lifetime of diabetes, heart disease and other chronic illnesses. Many of my adult patients who have led healthy lives for decades often wonder how they developed their diabetes, heart disease, etc. Unfortunately this seed…
Read MoreStress Follow-Up: When Is A High Heart Rate Healthy vs Unhealthy?
High Heart Rate: When is it good and when is it unhealthy? I received a lot of questions regarding my last post (be sure to read and watch the video if you haven’t) where I talked about how to use heart rate to monitor stress, and a prior post I did for my medical group on heart rate. Before I address some of the common questions and concerns, I want to clarify the abbreviations I’m using in this post: PNS: Parasympathetic Nervous System which regulates the relaxation response. Our goal is to activate our PNS as often as possible to SNS: Sympathetic Nervous System which regulates our stress (aka “fight-or-flight”) response system. Our goal is to activate the SNS intermittently on demand to optimize performance, but to avoid persistent SNS activation (even if it’s low-grade) which is a major underlying cause for most physical and mental disease. HRV: Heart Rate Variability is a…
Read MoreParents…Save Our Children!
Introduction This post is a call to action to anyone responsible in some way for a child’s health (parent, grandparent, aunt, uncle, cousin, nanny, teacher, etc.) and comes on the heels of our live children’s event this coming Sunday 3/15 from 2-5p. See here for details. The post below is excerpted from my book and was also featured in India Currents. We’ll cover more specific children’s topics in future posts like what to do with abnormal cholesterol in kids. Shally (pediatrician and children’s chapter co-author/my wife) and I are so committed to improving children’s health that we have released the children’s chapter of the book for free to anyone who signs up for the newsletter….if you don’t want the newsletter, just cancel it, but keep the chapter and please use it and spread the information to anyone you think will benefit. Children Mirroring Adults I sat in my medical clinic the…
Read MoreIntroducing our First “Healthy Hero”
Healthy Hero Series It’s time to start sharing some remarkable success stories from individuals who have read the book, follow the blog and/or have seen me in the clinic. For those of you on the fence about whether you should adopt the SAHS (South Asian Health Solution) lifestyle, I hope hearing from some folks who have found success despite facing similar challenges to you will be inspiring. Whether you are a sedentary, vegetarian engineer stuck in a cubicle all day or a working mother trying to manage home stress and work stress while striving to make healthy lifestyle choices for the family, hopefully you’ll find a story you can relate to. To me these individuals who have been sharing their success stories from all over the world are truly “healthy heroes” because they have not only overcome inertia and cultural barriers to achieve optimal health, but they are now spreading…
Read MoreLIFESTYLE SHIFTS FOR THE NEW YEAR
I already discussed in a prior post why I don’t like the word “resolution” which tends to set people up for inevitable failure. I discussed using the word “habit” instead, but this year I’m talking about “shifts.” Shifts are simplistic changes and substitutions you can make that require little to no effort or time. My book recommends several shifts to improve nutrition, activity, sleep and stress and I want to highlight a few to get you shifting towards optimal health in the new year. SHIFT YOUR COOKING OIL Time and Effort Required: Zero Some Potential Benefits: Reduce inflammation, chronic disease and optimize the function of every cell in your body Omega-6 and omega-3 fatty acids are essential dietary fatty acids that get incorporated into the membranes of all your body’s cells. The composition of the fats you eat will determine the composition of your cell membranes and how well your…
Read MoreCarb Trafficking, Body Fat Storage, and Insulin Resistance
SOME BACKGROUND After taking a bit of a hiatus over the summer from writing posts, I’m now back with a vengeance delivering this detailed post on carb trafficking and insulin resistance. Whenever applicable, I’m going to end my posts with a Children’s Corner section reflecting the experience of my wife Shally (a pediatrician), who works on the front lines of treating children with obesity and insulin resistant disorders. Insulin resistance is an incredibly complex concept which is influenced by countless factors including diet (micro and macronutrient intake), exercise/activity, sleep, stress, genes, etc. I want to use a simple traffic diagram I pulled from my book which has helped patients and lecture attendees tremendously in understanding how their daily habits influence their body composition via the actions of insulin. I am not going to dive too deep in this post about the biochemistry of insulin resistance since I want this to be…
Read MoreAre We Aging Faster?
Our modern lifestyles have turned chronological age into a virtually insignificant number. Aging is not just the number of years you’ve inhabited planet Earth, but rather the degree of wear and tear your body, brain, and vital organs are expressing at a given point in time. When I came out of medical training and started practicing in Southern California, I could easily estimate how old my patients were by looking at them since many of them were working jobs involving physical labor, often outdoors. In fact when we are taught to do physical exams, one of the first things we report is whether patients appear their stated age. For example, “Mr.Smith appeared older than his stated age.” When I moved up to Silicon Valley to start caring for a mostly sedentary, high-tech workforce, I lost the ability to estimate a patient’s age and often would not even come close, being…
Read MoreSee This Movie
FED UP: The Movie If a picture is worth a thousand words, a movie is worth even more. I encourage you to not walk, but run and see the movie FED UP, playing in movie theaters, which highlights the insidious, corporate-driven forces behind our current obesity epidemic. I saw this with my wife and two children and even though we are passionate and knowledgeable about nutrition, the impression this movie left motivated us to take our healthy choices to another level. I know I’ve discussed making social events more active by moving away from restaurants and movie theaters, but I encourage you to gather your family, friends, co-workers, or anyone you think is struggling with healthy food choices and may need a different mode of motivation. There is particular emphasis on childhood obesity and the garbage being served up in school cafeterias across the country. I also encourage you to…
Read MoreThe Most Important Exercise You’re Not Doing Enough Of
We need to completely re-evaluate our approach to exercise given the weight of current evidence. Back in the days when physical activity was a natural part of our life and daily habits, it was assumed that we took enough steps to interrupt the damaging metabolic effects of prolonged sitting frequently enough to disrupt fat storage and inflammation. So with this foundation of baseline essential non-exercise physical activity (NEPA), the recommendation was to add on an additional 4-5 exercise sessions a week. The core of NEPA includes activities like walking, climbing stairs, picking up objects off the ground and doing some squatting, all of which used to be a natural part of daily movement. It’s tragic that we now have to create a separate term for this (NEPA) and make a deliberate attempt to restore it into our daily, unnatural sedentary lifestyles. My patients today are sorely lacking NEPA which I…
Read MoreThe Book Is Finally Here!
After what seems like an eternity, my book has finally arrived! Check out the video below and read the book summary so you get a good idea of what this book covers. It feels so rewarding to share all of the experience and success stories from my consult practice and corporate health education and wellness programs in one book. This information is geared both for readers who are struggling to achieve optimal health and body composition, and for physicians and health/fitness professionals who are having difficulty getting their patients from diverse cultural backgrounds to reduce risk through lifestyle changes. The South Asian Health Solution is the first book to provide an ancestral health-based wellness plan culturally tailored for those of South Asian ancestry living in India, the United States and across the world – a population identified as being at the highest risk for heart disease, diabetes, obesity, and…
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