Why Do Most Indian Men Carry Abdominal Bulges?!

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One-time only offer so why do most Indian men have pot bellies now?

I have done another video on this previously, but I have some new information that goes beyond just eating too many carbs

So to get more accurate information about this topic. I'm bringing on Dr. Roshny who is an endocrinologist that actually lives in India

Doc, thanks for coming on. I wanted to just say hello and good to see you again

Yes, thanks for having me, Dr. Eric. It's been great to connect and be in touch again

Yeah, I wanted to really talk about

What's happening in India especially related to

belly fat and I know it's a big problem all over the world

But especially in India for several reasons. I did a video on this before and

This is kind of a part two

Because there's some additional information

After talking with you that I found out that I think I want to share that goes a little bit beyond

Just lowering your carbohydrates trying to lose weight

So we're going to talk about that as well

I think you were you're born in the US, but then you lived half of your life in India

You treat people as a medical doctor and as an endocrinologist. So

I'm so glad that I have someone who actually can give me firsthand knowledge of what's happening in India

So can you just kind of give people an overview of the type of

Health problems that are we're running into in India of having protruded bellies. Oh, yes

There's a lot we can cover there, Dr. Eric

You know, it's actually no longer you know type two diabetes is obviously something that comes into our world a lot as endocrinologists

We deal with sure, you know PCOS polycystic ovarian syndrome

We deal now with seeing younger and younger people getting sick from insulin resistance

Even people who shouldn't be getting insulin resistance. We think of someone with type one diabetes

We see them getting insulin resistance. So

India is not immune to what the rest of the world is seeing

We have little children now. It's there are some states in India that have one in three children with high triplets

Rides and fatty liver already on sonography and the protruding belly is hitting these young children

Right from when they're little and it's part of it could be nature part of it could be genetic tendency

But a lot of it if you take it in the right way is good news

It's environmental. It's something we have control over in terms of our lifestyle and our choices

But a lot of lifestyle changes are coming in where insulin resistance protruding bellies

We're seeing it across the board the diabetes metabolic crisis in India is exploding

We may not be the most obese country in the world

But we're up there in the top five in terms of maximum cases of type two diabetes as well as cardiometabolic so early cardiac issues

You know just dying to ask you this one question about that because you know just to keep this really simple

I think I'm assuming that most people know this but they might not when you eat carbohydrates in excess amounts

It triggers the hormone called insulin and then insulin is the hormone that not only stores fat

But it prevents you from burning fat. Okay, so that's what insulin is

But here's my question when you went through medical school

Then you studied endocrinology

When a doctor goes through this intensive medical training especially on insulin, which is a main hormone

But somehow it gets kind of disconnected when you get into the carbohydrate triggering insulin and I mean

It's just obvious when you step back now and look at it like okay

So if you have too much fat obviously have too much insulin, but in medical school

I don't know what tell tell me what happens when someone has taught that and

As far as an average medical doctor that you're an average endocrinologist and somehow they don't connect the dots to lower your car

Oh, yes

Yeah, you know that's

I had to look back to understand where did my basics

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Of first year of medical school from biochemistry where carbohydrate was the food group that triggers the maximum insulin response or the maximum insulin requirement

You know, there was a disconnect from learning that in first year of medical school

Till the time we came to second year where we were studying pharmacology already there was a disconnect where we were

Memorizing the types of insulin the NPH the quick acting the long acting the newer molecules how to prescribe them and

Then in third year medical school we went into internal medicine and we had Harrison's textbook and it was very little time spent on the

Lifestyle aspect and much more time spent on the prescription aspect whether it was the presence of pharmaceutical

Representatives in our clinics, you know funding or doing these little reminders of what to prescribe

There was very little time or energy in my medical school training for nutrition

Beyond the first year and then MD medicine internal medicine in the hospital, you know people who are sick and admitted

They're sick enough to be admitted to hospital

Really the concept of doing lifestyle discussion or nutrition discussion wasn't really

Relevant in a way it sounds bad, but here's somebody who's really sick. They're like, you know, lying in a hospital bed getting hospital trays

It's not seeming like the right time to talk about nutrition or carbohydrates. They're eating what's on the plate

And then I went into fellowship to become an endocrinologist and insulin specialist right and I'm still prescribing medicine

But I've not had the training hands-on how to change nutrition

So this is mind-blowing because I went through pre-med, but I didn't go to medical school

I went to a car party college. There's just not enough time to really learn the information

I had to pass the test

I had to memorize and get on to the next test because there's so much information being crammed down our throats and then but you don't have time to really

Go out. Let me apply apply this theory and then also

How can we use this information practically? It's just not talked about so I guess what you're saying is like

You're taught this information

But then there's a just a disconnect on the diet part or the food part a big disconnect a big disconnect or the nutrition part

Yeah, I wouldn't say that doctors were getting

Hardcore or thorough nutrition training. I wouldn't say that there must have been a point when you graduated

You're going out there just doing what you were taught

There must have been a shift can tell us what happened at that point. Yes, so

I I noticed you know when I was an endocrin fellow that we as fellows in training would run around

Run around one side of the corridor running into the patient rooms to do the consults and then talk to our senior doctors and get the sign off on the medication changes

We wanted to make and one of the prescriptions we would write along with the insulin or the medications for diabetes for example

Was go to this diabetes class and I was like well, that's interesting. There's a class and it's on the other side of this corridor

Luckily for me was on the same campus in the same building

and

So as I was graduating I got you know permission to go and sit in on some of these classes by the diabetes

Educators because I was curious about the behavioral elements and what are they teaching over there that might be useful to my patient that

I'm asking them to take out time and come again to take this educational course

So I didn't I was having a bit of formal like I didn't want to miss out on what was being said

So that was my first exposure to the impact of nutrition and you know, Dr. Berg

It's almost like a paradox. It's like I had blinders on because

endocrinologists are the most trained doctors when it comes to treating people with type one diabetes when I have to prescribe insulin for some of you

right and

over there where

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Taught insulin carbohydrate ratio, which means for how many grams of carbohydrate

How many grams of insulin am I trying to give this patient and I teach the patient that is how much they need to be

Injected for that meal and yet this knowledge

Stayed there and it didn't come out until much later when I was like wait a minute

That's a secret formula if I lower the carbs. I lower the insulin right in front of my face

Okay, I mean it's seeming like you're talking about a type one diabetic right they have to take insulin because they don't have insulin

So they can't regulate the sugars because insulin lowers the blood sugar

So obviously if this is the amount of insulin you take is dependent on how much carbohydrate you eat

What you're talking about is that information just did not quite sink in right away

It didn't move to other parts of my career

It just stayed in this place and so in type one when I was walking with someone

I would say hey if you don't want so much insulin because you're gaining weight

You're getting this bit of a belly. You know you started out normal weight a lot of people start out normal weight

And then the higher the insulin dose goes and type one they start gaining weight

And so we would say well if you reduce your carbs

We're gonna have to give you less insulin

So that was an obvious thing there

But it just didn't translate to all areas of my career until later

Where a series of events when I decided to move

From the United States to India

That's when a bulb went on is you know, I love these classes that my patients are getting in Chicago

And I want to learn that so I can carry the educational material to India

I don't want to just carry my insulin prescribing knowledge and medicine prescribing

I want to know the education piece because I felt like that would connect me to the culture in India if I did the education myself

I would listen I would hear I would understand what's going on in India because I'd been out of India for 10 years

And so I wanted to use the educator hat

To connect back with my my culture

Through those listening experiences I started hearing what was going on with people's nutrition

And that that really started in 2011 and by 2013 I was just making a lot of progress

With helping people realize that if they want to avoid more medicines or getting onto insulin and type two diabetes

We had to show them the relationship between carbohydrates

And the insulin that was giving them this gaining of belly and all this weight gain in the wrong areas

Wow okay so fast forward you're in India

Let's talk about carbohydrates

There's a lot of carbohydrates in the world but definitely I think and when you go to a restaurant

You have different cultural festivals you have everything kind of revolves around carbohydrates

What are the top carbs that the Indians eat?

How about I walk you through a breakfast launched in or like that

Okay, so what is considered a light breakfast

Because we've been as affected by the low fat low calorie

Unfortunate messaging that went around probably from the 1970s

India has been listening to that and has been badly affected by trying to do a calorie or a low fat approach

So they think low fat or a light breakfast is preferred

Which ends up being a lot of carbohydrates

So breakfast options include

Some people might do like a if you're from the north of India

You might do a paratha or like a piece of bread or a roti

If you're from my area of the state which is Gujarat

You might do like a spicy kind of a bread like a tableau

Some people love to have tableau

These are some common breakfast items

If you're trying to go healthy you might do cornflakes or you might do musily

And you might do juice

Some people will do a bowl of fruit

Some people are told in India stay with only fruit in the first half of the day

So they'll load up on their fruits in the morning

Or they'll go for the

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They're morning walks and then they'll have a fruit juice to sort of power

Power that walk

Again these are all carbohydrates all processed and refined

Some of them sugar

Oats people have taken to reading and hearing that oats are heart healthy

And that same messaging has been in India as well

So they might do instant quick cooking oats

And then they might do versions of that where they do oats

Opama are oats idli

So they think that by adding the oats into the other Indian dishes

They're doing something better than just the rice or the wheat

So that's just breakfast

And I'm probably missed some

If we go to lunch

You and some people do a mid-morning snack

Again, if they're being health conscious

They may have been told to have a fruit as a mid-morning snack

If you do that breakfast one and a half hours later

You're going to need a snack because it's going to

Put you in a state of hunger

Yes, because of that big insulin spike in the morning

And you're hungry

And this is the classic pattern I see is small frequent meals

Hungry all day

Cannot go more than three hours, four hours without feeling hungry

And wanting something cravings, a lot of cravings

Lunch

Typically is either roti or rice

Some people if they're again health conscious

They may be switching from wheat

They may be switching to millets

And the government of India is trying to actually promote more millet usage

I'm okay with the millet if it would be a whole grain

Where you can actually see the millet

But a lot of these have been pulverized into a powder

And they're being converted into snacks

Or again roti or flatbread made from flour

So you've done a lot of processing to these grains or millets

So you have some form of a flatbread or rice

With a side of maybe a vegetable or a doll

If you're vegetarian

If you're carrying lunch from home

One good thing that I still see in India

Is a lot of people carry lunch from home

But we have a very hot climate

So someone who's cooking for you in the morning

Or you're cooking your own lunch and carrying it in lunch

Usually you don't want it to be something very liquid or

That's going to spill or leak or go bad

So it might be more on the dry side

So you end up not having a lot of protein in these lunches very commonly

If you're not careful

You'll end up being protein deficient at lunch as well

There's just basically maybe a grain

Or a processed grain and some vegetable

Maybe if you eat animal protein

You'll have a small amount of animal protein at lunch

And then is there a mid afternoon snack?

Oh yeah

So again this is where a lot of hunger pangs hit people

I give a survey to all of my patients when they come in like an intake form

And so many people mark off that five o'clock is the worst

Four o'clock is the worst

So we have a chai culture in India where we love our chai

And so the afternoon or you know mid evening

Early evening four o'clock three o'clock chai

A lot of people want to have some dry crunchy munchy snacks

Again these may be light because they're fat free

And they're like baked and roasted and not versus fried

So people think it's good for you

This could be puffed rice

It could be millet flakes, millet chips

A lot of these crunchy snacky things that people want

Maybe if you're trying to be healthy you might do a fruit

And then for dinner

For dinner

Again, not everybody prioritizes protein at dinner

Sometimes if again I'm a Gujarati

So I know them the most again highly vegetarian by preference and by culture

So dinner they don't want the sort of bread

And like the flatbread and the vegetable and the dal combo

They want variety at night

So they might do a variation of a pizza or a pasta

Or a lasagna or a Mexican dish

You know I'm going to use some Indian words here

Because you know this is for them

Is like rugga da pactis which is a lentil soup

And potato fritters you could call them

We're looking at a lot of carbohydrates

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So if we take a look at a carbohydrate

I think there's a really big confusion

And what a carbohydrate is because it's not just one thing

It's basically three things to keep it simple

You have fiber that's a carbohydrate

You have sugar which is a carbohydrate

But there's a third thing

If you deduct the fiber in the sugar

There's something else that's left

And this is what I think people don't

Even they're not aware of what that is

And that would be a starch

And what is a starch?

A starch is a bunch of sugar

It's more sugar

It's more hidden sugar

Especially the way that they process it around the world

So if you

You know we talk about how much sugar an actual person is consuming

It's a lot per day

But if we include the starches

And we look at the percentage of calories

Of combined carbohydrates

And that's all the carbohydrates

We're looking at what is it 60, 70

Maybe even 80% or more of their calories are carbs

Right?

Unfortunately

Yes

Especially if you're vegetarian

And you've just not met someone who's educating you

About lowering your carbs

Your default Indian choices

Are going to be more than half carbs

Wow

How can someone start lowering their carbs

Because obviously we need to reduce insulin

To solve this problem

Live in India and actually do this

And actually maintain

A vegetarian lifestyle

We want to talk about that

There's a second

Problem that

You've mentioned to me

What some of these foods do to our digestive system

Like we get a lot of bloating

And it's going to make you look like you're pregnant

You're going to give you a pot belly

Do you see that in your practice

People coming in with

Distended stomachs

Every day, Dr. Berg

Every day

And again in that intake form

Because I'm you know

Internal medicine

Base always

And then an endocrinologist after

So I ask about all the organ systems

Because I want to look at you as a whole

So I'm asking about digestive symptoms

And we did a little analysis of our practice

And I was surprised

That the topmost complaint

People had when they came in

Was digestive complaints

And I was like

I'm not a gastroendrologist

But they're suffering from this

The good news was

Even though they came in with the gas

The bloating, the

You know, distended belly

It would go in and out two, three inches

Depending on what they ate

We've been able to sort of crack

How to help them see that

Phenomenon change

Just by working on their food

The problem is

And I'm sure you'd probably see this

A lot of your patients are on antibiotics

For PPI's

And it just gets worse and worse and worse

So

Then what happens

Is you get this overgrowth

Right?

All this candida and stuff

And now we're in a situation where

If they just eat a little bit of fiber

They're going to feel like there's a balloon in their stomach

A human or an animal

Or even an insect

Will continue to eat

Until they satisfy their protein requirements

So do you see this

In your practice?

Every day

I see people again not satiated from their meals

Wanting something more

Sometimes they describe this as cravings

Sweet cravings

They somehow they want more sugar and sweet

And I suspect it's because they've just not been nourished

They're still looking for that energy somehow

And protein should not be used for energy

But there's something that's getting misinterpreted

As wanting to seek out sugar

And when you're dealing with the high insulin that we talked about

Adding more sugar just keeps you really stuck in the same vicious cycle

But I've been doing diet recalls for my patients

Encounting their nutrition since 2011

Myself because I was you know the educator for my patients since 2011

And in India

I see people coming in when they first see me

Most of them are less than 50 grams

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Protein per day

And a very large majority of them are getting less than 25 grams

12-5 grams of protein per day

This is interesting because when someone gets enough protein

They're going to be satisfied and the likelihood of them snacking

And like if they went on a low carb diet now

Without satisfying the protein

It's going to be really hard to fix that problem

Exactly because you're taking someone who's hungry all the time

And you're telling them to reduce their carbohydrates

But then

Right

So like how are they going to be satisfied, right?

Yeah, right exactly

So what I've learned is to flip the process

As yes they're high on carbohydrates

But that's all they're using to sort of almost like mechanically

Fill the stomach with something

And feel that stress

And you know it's very interesting because I think this is the origin of the myth

That happens in India or circulates in India

Is that protein is heavy

And I'm sure that

When they say protein is heavy

What they haven't understood is that's what satiety is supposed to feel like

It's supposed to fill you up

And so when we increase the protein

They start feeling full and they're finally like

Oh, I'm done

I don't need more

The thing that turned me around

Because I used to live on pure carbs

Huge muffin for breakfast and cereal and I would do that

It took me until 11 o'clock in the morning until I can wake up

Mentally

And then one day I started having protein for breakfast

And boy that was like

A miracle I can actually wake up

How does someone being a vegetarian

Increase the amount of protein to start the day off right

Yes, this is again something we're trying to solve for every day in practice

And we'll stick to vegetarian because it's so much easier

And you've got so much content out of for your audience

About how if you are okay with animal protein

It's just so much easier

To get your protein to happen at each meal

But the unique problem is for someone who's, you know, choosing to be vegetarian

Within India

There are some vegetarians who are okay with eggs

And there are some who will not even go in your eggs

Just it's absolutely against their belief systems

And I cannot even get them to take eggs

Which would be a really good quality whole protein for them

So many vegetarians in India are okay with dairy

And so we use that a lot

Let's just talk about like specific types of foods

That they can have related to dairy

Right and you know, Dr. Berg

One of the things I've done is I try to reduce the habit friction

So I kind of look at what they're already eating

So that they don't have to all of a sudden

Lip their grocery list

And do something out of the way that's not going to match their running kitchen

India is a lot of large families living under one roof

A lot of different tastes and preferences

A lot of actively running kitchens all day long

So the idea is to not shut down the cooking system that's working

But to start with baby steps

I know what would be ideal is to get these people

To 1.2 grams of protein at least per kg body weight per day

Every day

But sometimes I have to start with

If I'm trying to get to 80 or 90 or 100 grams of protein

But I'm starting at 20

I'm like how can we make this 30?

How can we from your existing menu?

So I'll look at what dairy they have

I'll look at what legumes they have

I'll show them how

Okay, these come with some natural carbohydrates

And I make them use my app

And I made my own app

Because the existing apps out there

They do a lot of calorie counting

And as an endocrinologist

You know, we want them to focus on carbs and proteins

And the hormonal basis for why their belly is coming out

And not the calorie way

Because just reducing calories just hasn't worked

And my app is populated with Indian foods

And me and my team have counted out each food

And we keep adding new things

To the back end

To show you your carbs and proteins

So we're like, put your foods in

And you'll start to see where you are on your carbs for the day

Where you are on the proteins for the day

Let's see if you can start

Diling your existing proteins up

So that means if you took legumes

Double them

If you took these carbs, can you have them

And that's like the easiest way for me to get them started

And so, obviously we have the yogurt

Do you do kefir as well?

It's available, it's a bit of almost like a privileged food here

It's not easily available everywhere

So I wouldn't say it's something that the masses of India

Are going to be able to access

It's maybe in the very health conscious big cities

In the refrigerators

Okay, so then we're talking about like yogurt and then all cheese

Yes, they'll do milk, they'll do yogurt

They do homemade Indian paneer cheese

Which is like the fresh

You split the milk, cartil the milk

And you get this fresh paneer

I can get by with a meal with um

And do just fine with cheese

So cheese, I do a lot of cheese in my diet

And that's a really good protein source too

Because when you have cheese that is fermented

It eats a lot of the milk sugar

Then sure you can sneak in some nuts and seeds and nut butters

But if you're pure vegetarian

I know we're not going to reach 1.2 grams per kilo body weight

Without adding a protein supplement

And people will say you know

Oh, you should avoid powders and you should avoid processed food

And I agree

But in a world where we're not touching animal protein

You're touching processed carbohydrates anyway

You're touching flowers

You're touching packaged, you know, shelf stable things

That are just not fresh

And they're like instant eat

They're no cooking required

If we're going to choose processed

Maybe this is the one

Vice is to take a protein supplement

And from all of those

Way is really not that processed

If you think about it

It's just dehydrated liquid

From when you split the milk out

And get the solids out

The liquid is the way

So that would be the least processed

It's actually a complete protein as well

So I think that's a great

Great thing to do

So let's say a person wanted to get

A good amount of the protein from way

I guess it would list it on the label

How much they would need

But I don't know if you have any simple ways

That would be

Yeah

So one scoop

Gives you the typical way the packaging comes here

One scoop gives you about 25 grams

And so the way I ask

To do the math here

Is if I've given them a target of 1.2

Let's take a 60 kilogram person

We're aiming for 70 to 75 grams

I usually go on the higher end of estimating for them

Because they're plant-based

It's vegetarian

I know the availability of these is a bit on the lower side

1.2

And then I'll just like throw in an extra 5 or 10

Just to make an easy number

So 75

So 75

I can divide that easily 25, 25, 25

Breakfast, lunch, and dinner

Might be that you need the way protein scoop

If you find that when you do your math for the day

Is you know what you're going to eat

You know you're going to have some legumes

And some lentils

You know you're going to have some paneer

Some soft fresh cheese

You do the math

Or some people have started plugging it into my app

As they plan the day

Is oh

That's going to get me to 40

So I'm short by 30 or 35

So then they'll do a scoop or a scoop and a half

Of the protein shape

By starting with the protein

You're going to start being satisfied

If someone's willing to do eggs

How many eggs

Because some people are concerned about cholesterol

Right?

So once you mention that point

Yeah

I mean there are days

Dr. Burg that I eat eight or ten eggs a day

If I haven't thought about what to eat

Or what to make

Or cook

I'm like you know what it's just easier

Let me just do the eggs

Right

And there's been no real link

That dietary cholesterol

Raises the bad cholesterol

This is a myth

That even the American Heart Association has come out

And backed off from saying

It was sort of bad information

Told to us in the 70s

And it just really stuck

So I have to reassure them

Is it's not the eggs that we're going to worry about

We're going to look at other things

To make sure you're healthy from a cardiac standpoint

Oh that's great

Now do you in India do they have a lot of

Let's say tofu things like that

Is that an option or no

It is

Again I would say that it's an acquired taste in India

Tofu versus paneer

It's texturally different

The flavor is different

I love tofu because of the profile it has

In terms of carbs and proteins

So we have a lot of tofu in our house

It's also one of those things that

If you're using non-GMO soybeans

Can be expensive

So if you're finding there are Indian made

And India actually produces quite a bit of soy

Soybeans

And a calling of mine

Told me that India does non-GMO soybeans

And so if you can get local Indian made tofu

It's picking up in popularity now

So you're getting tempeh now in India as well

And the Indians are early into their spice

So you get ready to eat

Tempe that's been flavored and seasoned

With like Indian spice profiles

So that they can hide the taste of the tempeh

Because that's a bit funky to get used to

So the big cities do have tofu and tempeh

So let's roll right into digestive problems

I know one of the great things about India is the spices

And you have turmeric for example

That help with bloating

Help with digestion

And so they probably offset some of the things

I know even in America when you go to an Indian restaurant

They will give you some some spices

After courses coated in sugar

But you know you're consuming spices

To kind of help somewhat the bloating

Is there a common spice that

Indians use after they eat

Every kitchen starts with turmeric

Every meal has turmeric

Every day there's turmeric

Every day

But we still have digestive problems

We have cumin

In almost every day cooking

There's a small community within India

That won't touch onions and garlic

They have religious beliefs around that

You did mention about the antibiotics and PPI's

The good and bad about India

Is these things are available over the camera

So people

People self-prescribed

Self-prescribed

Wow

I think what's happening

Especially that you just told me that information

If someone has taken an antibiotic

Sometime in their life

Now you're going to limit the

The microbes are going to help you digest

And so over time

Now you can't digest this

Now you're getting gas from that

And then those microbes need to be replaced

Another thing that we want to talk about

Is like fermented foods

Are there fermented foods

In India?

Yes

The ones I prescribe are somewhat imported

In the sense that they come from other cultures

Like the sauerkraut, kefir

Or the kimchi

In terms of Indian fermented foods

There are some

But again they can't tend to be on the spicy side

So the fermented yogurt is one

Like there's a digestive beverage

That a lot of Indians won't have after the meal

Which is yogurt in water

So diluted yogurt is shaken up in water

And they'll put some powdered human in there

Maybe some spices in there

And they drink it like a digestive after their meals

When we talk about starches

You know people think oh potatoes

But that's not what's in a lot of foods

You have modified corn starch

Molto dextrin

Modified food starch

Let's just touch on that

And how that can

Eliminating those foods can

Majorly help with the bloating

We have to teach our patients

You know we do a lot of label reading

Classes with them

Where we show them

How to look for these hidden ingredients

Is they're not understanding

The the the technical words

You know it's not recognizable as a starch

You know it's obvious if it's pasta or it's obvious if it's a potato

But these you know strange long words

We have to make them understand how to find those

And even the way a starch hits you

You know this is one of my sort of arguments

Is sure every culture has its traditional wisdom

And we have our traditional

Millets and our traditional grains

And our non-GMO wheat

That's been around for men's centuries

And people want to talk about oh but we're eating what our ancestors ate

The thing is when you powder these grains

You're taking that starch that was in the middle of it

You know the starch was meant for that little seed

To go in the soil

And in the dark where there was no sunlight

To be able to make some energy for this little shoot

So that it could poke enough energy out

And get those little leaves up

To start the photosynthesis and get energy from the sun

So that starch was meant to be given at a specific time

To this plant underground

We've taken that seed and crushed it to a level fine powder

And we're getting that starch right up front

And it's really sad because people tell me

Oh proteins are difficult to digest

And I think what they're going through is exactly what you described

Is the starches are hitting them first

The good bacteria in their bodies have been destroyed out

By some lifestyle choices, by medications

And then they're trying to pop some prebiotic probiotic supplements

And so they're just in this endless cycle of you know medications

And just not getting better

Are you doing grain base? Are you doing plant base

And then also like raw vegetables

A big part of an Indian diet

Or is it just cooked vegetables

Some cultures do a lot of salad

You know small quantities of just fresh

Freshly chopped really herbaceous

You know lovely light seasonings

Like cilantro, mint

We do have lovely herbs

That you get it's a warm country

You know there's lots of availability of greens like that

Micro greens are becoming popular here

And some of the foods will be cooked

Now there is a spectrum here

Like sometimes it's almost like a generation gap

Where people my generation want their vegetables all dente

Like where there's still some bite

And sometimes it's the kids and the elders

Who really want their vegetables cooked into a mush

Almost like it's unrecognizable

There's no chewing required

Yeah yeah that's uh yeah

It's like you take some spinach

And you just pulverize it to nothing

That's another thing like I think could help people

With their digestion is having like more salad

Than the greens that can help with the bloating as well

Yes so we tell people go up on the fresh vegetables

Go down on the greens for sure

But it's always that whole process is after we've up the protein

So my first agenda in any consult

Is to up the protein first

There are times where I have to tell people

Look I can't make progress in your metabolic goals

Until we get that protein to happen at each meal

So here I sort of really make it accessible to you

Is instead of saying reduce your carbs

Because people are like I'm not eating any carbs

They don't think they're eating carbs

Right they're like I'm eating home food

I'm eating freshly cooked meals

I'm eating my traditional Indian diet

So I have to say okay let's reduce your roti

Your rice

Your barata

So I list out the Indian words for these

Carbohydrate predominant meals

Opuma, poha, chakra, etc

These long Indian names you know

And let's cut it to half

That's after they've up the protein to double

Because most people have enough room for me to say

Just double your protein

Because they're so deficient on protein

Even if I double

They're not going anywhere near access

Yeah

This is a tricky problem

Because I know in America

We have a lot less vegetarians in big ends

So you know we can recommend certain animal meats

But not not another cultures

The trick is how do we

How do we do this to lower the carbs

I think you're right

We need to start with the protein

Because that's going to make it easy to do

Or a lot easier

It's going to be much harder

So I always do the protein conversation at first

So I'm not taking a hungry person

Who's full with the two rotis

Or the one and a half cups of rice

Let's say they're eating two chapatis

Or rotis, breads, flat breads

Or you know

Two cups of rice

Let's just make a number

They're eating one cup of vegetables

And they're eating one cup of

Legumes, lentil soup, dal

I will say

Can you cut the

Roti and the rice to 50%

And can you double

The vegetables and the dal

Two cups of those

And two cups of those

Can you do that

And they'll be like

I'll be so full

I was like

You want that, right?

You don't want to be hungry all day

So

When we do the increase in the vegetables

And the proteins

They themselves are able to then

Self taper the carbs

And in India

Again, more and more people are getting exposed

To the idea of wearing a CGM

A continuous glucose monitor

Which is a little wearable chip

It's a device you can wear for two weeks

And when they wear that

They can see what happens

With their carbohydrate intake

How their glucose levels are spiking

And then we have them run the experiment

As C

You had two servings of this grain

Your glucose spiked up

Tomorrow I want you to try

That's a great teaching tool

Right

And why don't you cut that grain to 50%

And then tomorrow see what happens

Then it's not them taking my word for it

It's them and their body having a conversation

This is amazing

So um

For those of you

That need to work with

A very competent physician

I want to put your link down below

Where they can get a hold of you

And they can learn more about your website

And your in your program

Because there's so many people out there

That there are on medications

That need assistance

That this is a new thing for them

And I know that you have several programs

Amazing book as well

That I'm getting through right now

I'm halfway through it

Which is filled with

Just gold information

So I'm going to put those links down below

But it's been a pleasure

Discussing these topics

And I think

There's a lot of great

Ideas for people to start implementing

On a regular basis

And uh

I think

If people could just try this

They're going to find that it's going to work for them

I'm just so glad to talk to a medical doctor

Especially an endocrinologist

That is

Primarily focused on

Someone's food

Because

That's very rare

Yes

Today we talked all about food

And it's the first step

It's definitely the first step

To helping the body do its thing

Yeah

Exactly

Thanks so much Doc

I really appreciate your time

Thank you Dr. Burke

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