so whenever a person develops diabetes I always used to say the disease had started 20 years back when the person was in childhood some black patches would have formed in his neck or axilla so many children have that we call that as acantosis NRI the black patches this is the first sign so in your practice what age do you see that usually from 5 years years from 5 years hello guys welcome to another session of our podcast gut feeling with Dr pal in this session I talked with Dr Arun Kumar he is one of the prominent YouTubers talking about low cab diet he's one of the Pioneers in YouTube he has guided me in multiple levels and I absolutely love his approach because he talks about how to protect our insulin levels it is not the insulin resistant which is the problem because of insulin resistance body is producing too much insulin that too much insulin is going and damaging every organ it goes and damages the ovaries that is called PC the child is not eating properly from when is the child not eating from birth then how did your child reach 10 kg or 12 kg I don't know but the child is not eating at all so this is a standard complaint they say because they force feed the problem starts from the whenever a child was obese the cause was endogenous so endogenous means endocrine some syndromes genetic syndromes but statistically currently only 2% of the kids with obesity are actually genetic and endocrine causes 98% is exogenous food activity yeah I'm fine so both of us we talk a lot about diet yeah okay and I talk a lot about insulin okay and I say that you know in my research as well and also you know based on multiple studies we know that as long as we protect our insulin uh we give rest to the insulin people are happy okay so my method of time restricted feeding where you don't eat late at night you know like 10: p.m. 11:00 p.m. according to the Circadian rhythm it doesn't work accordingly so if you don't eat late at night insulin is taking rest at night so that it will come back in the next day and with full action 100% quality and then we'll give you the best effect that that you need you have been advocating low carb diet okay and can you tell me how low carb is affecting the insulin uh from a pathophys standpoint yeah so so so what you are advocating is we have to uh the sunrise to sunet so and based on the Circadian rhythm so hormones the insulin the effectiveness will go down after the sunset correct so you advocating to reduce or stop eating after 6 p.m. or 7 7 p.m. late at night yeah so what the concept of low carbohydrate diet is that um this uh it is not it is not I won't say it is opposite to the intermittent fasting or anything it is all complimentary compliment correct so generally even in low carbohydrate we combine intermittent fasting and in fact intermittent fasting works best when combined with low carbohydrate I see so ultimately it is everything about controlling insulin so that is the one key correct correct so how we can control insulin or we should know what are the factors that trigger insulin so among the diet the carbohydrates are the carbohydrates are the most important source of food that actually triggers the insulin to the highest level highest level next is protein but when compared to the carbohydrates the amount of insulin triggered by the protein intake is pretty much low and actually fat it actually triggers insulin to the least possible correct so that is the thing people should be aware of so we always think okay whenever because insulin resistant obesity we always associate okay fatty items fatty items will affect insulin no no actually even less than the protein fats produce the least insulin spikes inside the body so this is one thing and next thing is so these are the nutritional factors the next thing is time restricted feeding so whenever we are eating more frequently the insulin spikes are maximum whenever we consolidate our meals then again the insulin spikes are minimum then again whenever we are fit and our activity is not sedentary whenever we are fit and we are doing some cardio or strength training definit the insulin sensitivity will be better whenever we are sedentary the insulin sensitivity will so these are the five factors the nutrition the eating time and the physical activity so these are the three factors that control the insulin inside the body so your approach is from from one angle one angle so time restricted feeding acts from one angle one angle so in another angle say in the same time restricted diet if a person decides as you comically say if I want to add two plate of biryani between say 12:00 p.m. and 600 p.m. will it work two plate of Biryani two plate of Biryani might not work yeah why even though the insulin function is maximum so say he wants to eat he wants to follow an eating window 10:00 a.m. to 6:00 p.m. okay so 10:00 a.m. he takes some four rotis or four chapatis something like that uh then by lunch or by evening he wants to take two full plate Biryani and it will be loaded with carbohydrates loaded with calories so loaded with everything correct so will the same intermittent fasting work in this case scenario not that much yeah not that much because what we eat during the intermittent fasting what we eat during the eating window matters matters so that is where the carbohydrate restriction comes in so so time is one thing that controls the insulin then the among the food items the carbohydrates are the most potent source so whenever we restrict carbohydrate intake the insulin spikes are less so with that we are able to reverse the diseases associated with insulin malfunctioning or insulin resistance so what are the diseases associated with insulin resistance the first thing is obesity obesity diabetes that is particularly type two diabetes then dyslipidemia that is cholesterol generally the people say cholesterol issue but actually it is high triglycerides so because high LDL cholesterol is a different uh type alog together it's a different game it is related to genetic issues so whenever we mean dislipidemia or high cholesterol actually in insulin resistance it is high triglycerides or low HDL cholesterol so that is one thing then fatty liver so as we keep repeatedly saying fatty liver PC fem and gout high uric acid so these are the things related to insulin resistance so we say insulin resistance that means insulin is not functioning properly yeah so because of insulin resistance what happens inside the body the pancreas secretes more insulin corre that is hyper insulinemia so excess insulin inside the body because the whatever insulin is so instead of 10 units uh the body the pancreas secretes 30 units 40 units 50 unit to compensate to compensate so whenever we see obese patient and the sugar levels will be normal when we check we we check actually hba1c that is the glycosilated hemoglobin it is actually better than fasting and postp blood sugar correct and we also check check the fasting insulin levels so they will be happy telling that I'm obese but sugar levels are normal but the fasting insulin levels will be 50 that means his pancreas is already overwork five times to prevent diabetes so already so whenever a person develops diabetes I always used to say the disease has the disease had started 20 years back when the person was in childhood some black patches would have formed in his neck or axilla so many children have that we call that as acantosis NRI the black patches is the first sign of insulin resistance so so in your practice what age do you see that usually from 5 years years from 5 years but when they say they come for cough and cold when I say your child has black patches the child might get develop diabetes next time they won't come to me so that is the problem so they want only the things they want to know at that time I have come for cough and cold you have to give medicine for cough cold and fever why are you telling a small child that he will develop diabetes such a bad doctor so they'll change where do you see those spots back of the neck yeah back of the neck so it will be like line and some people they recognize the problem but uh they will keep on applying some creams natural remedies thinking that it is some external problem wow so probably the dirt is not getting washed away properly they change the Soaps frequently is actually whenever the black patches are there in the neck and the axilla under the arm under the arm so in the black PES are there in your child you know 5year old or 6y old 10y old definitely it's a sign of first sign of insulin resistance wow in those children we check fasting insulin levels their sugar levels everything will be fine but fasting insulin levels should be high so that means that child the 10-year-old child is going to develop diabetes at 30 years so when I diagnose a 30-year-old patient with type 2 diabetes the disease had started 20 years back so that is the problem so in low carbohydrate diet so we'll come back to that in low carbohydrate diet so as I said that is hyper insulinemia the excess insulin is causing this acantosis also it's linked to that corre it actually stimulates the melanocytes the pigment producing cells then the excess pigmentation everything is related to more insulin so you have to understand one thing it is not the insulin resistant which is the problem because of insulin resistance body is producing too much insulin that too much insulin is going and damaging every organ M it goes and damages the ovaries that is called pcod so the excess insulin is converting all the whatever food that we eat and getting converted into fat that is obesity so in obesity what we say uh the obese person if you say Okay restrict your calories the person will not be able to do that because what happens if he tries to restrict his calories already he is insulin resistant correct and there are circulating insulin levels are very high so if the C cating insulin levels are pretty high and the insulin level is waiting to store fat because it is not able to act on the muscle cells to convert the glucose into energy because he's already insulin resistant so if he is four idlies or four R if in a insulin sensitive person the whatever glucose is there in the from the Ries everything will be getting converted into glucose and everything will be getting converted into energy correct in an insulin resistant person so probably the two idlies will go to the skeletal muscle cells and two idlies will be converted into fat so even after taking four idlies for breakfast by 11:00 a.m. his energy source will get over he will get exhausted then he will feel hungry then he will take two more vadas then one coffee with sugar then again after 1:00 he will get hungry then again after 4:00 he will take a meal another some carbohydrate meal only then he will feel comfortable why this craving why an insulin sensitive person doesn't have this craving but whenever the insulin resistant develops it's a chain reaction so he keeps on craving for more cops and the excess cops are actually getting converted to energy it is like uh say if there's a pot we want to take carry a pot full of water the pot has already a hole in it just leaking yeah it is just leaking so whatever he POS in it half of it is already it's leaking so that is the problem it is not actually going out here in this case it's staying inside the body body and gets converted to Fat I see so uh if we want to break the chain so if we reduce carbohydrates what will happen if we reduce carbohydrates then what should we eat so definitely we have to have something for energy so many people mistake low carbohydrate diet as some starvation diet it is not just stopping carbohydrates and taking only vegetables because we can't get enough macros we have to have either carbohydrates proteins or fat for our main energy so if you reduce carbohydrates we have to increase the fats increase the protein so we call it lchf people say low carb high fat correct I would say lchf low carb healthy fat when say high fat everyone gets a fear okay it's heart attack it will get converted it will block the clock the arteries it is not healthy fat so we can choose healthy fat options it is not high protein it is adequate protein most of the people are not getting the enough protein so healthy fat adequate protein adequate fiber in the form of vegetables and low carbohydrates that is the carbohydrates from the millets grains corre any form of carbohydrates definitely know to all the refined cops processed foods all the packed food definitely the contain tons of carbohydrates so when you cut down all that increase the proteins increase the healthy fat increase the fiber then what happens the insulin level comes down comes down so once the insulin level comes down every problem gets corrected on its own automatically so every problem means the sugar levels start plummeting down from day one person with obese or even in it works even in lean type two diabetic even the person is lean and type two diabetic he not reduce weight at all just because he has reduced the carbohydrates the insulin requirement is less so from day one his sugars will start falling down from day one for a diabetic we will say reduce our medications into half for 80% of the type 2 diabetic with the low carbite we will be able to wean off the medications completely completely within a span of 15 days or even one month so that is thing then every other problem so high triglycerides so high triglycerides people think okay high fat we should not eat fat but actually people should understand that high triglycerides is due to conversion of the excess glucose into fat by the excess insulin so when we reduce the Cs reduce the insulin there is not much glucose to get converted into triglycerides triglycerides will come down come down correct then the same triglycerides are getting deposited in the liver fatty liver comes from so triglycerides we have seen triglycerides 700 800 normal is around like 400 right 300 normal is less than 200 less than 200 but whenever this insulin resistant people usually have triglycerides in the range of 500 600 700 and uh many even doctors by mistake just give statins statins reduce only the cherol LDL cholesterol they don't reduce the triglycerides at all that's a separate group of drugs for the fibrates but still fibrates even fibrates do not reduce trigate to that much extent correct say if that is 600 it will reduce to 400 or fibrate is the drug to lower the triglyceride lower the triglycerides but in I mean sorry similar to Statin fibrate is also a drug but usually when we think that cholesterol is elevated everybody is on Statin Statin that is the problem so but if the same person is started on low carb diet triglycerides will fall so people will fear that I'm already having enough fat in the blood so what will they happen if I eat more fat but actually the contrary happens because of reducing insulin levels actually triglycerides will come down from 600 or 700 to less than 200 200 fatty liver we have seen even Grade Three fatty liver reversing to grade one or even normal by the end of 6 months or 8 months of low and in case of pcod it works wonders because in pcod either obese or lean PC that is the number one more than 50 60% of infertility nowadays is due to PC correct in pcod again the problem is hyperinsulinemia excess insulin acting on ovaries so more androgens that is the male hormones instead of female hormones the hormonal imbalance affects the ovaries ovulation is affected so infertility so again reducing the cops so I've seen people like 10 years 12 years of infertility uh who have tried IVF multiple times IUI 15 times 20 times IVF 2 to three sittings but with simple low car diet they just get consumed within four to 5 months without any other drugs m so to such an extent it reduces the insulin level so everything is revolving around the same insulin same insulin same insulin so one additional Advantage uh over the time restricted is that in time restricted feeding for obese people the effect will be very good it will be very good and it can be even comparable to a low carbohydrate diet right but in case of lean people lean diabetic lean fatty liver and lean PCOS uh in any other restricted diet the weight loss will occur but only in low carb diet without reducing the calories they can still follow a low carb diet a 50 kg wom with PC can still follow a low carb diet without reducing weight but she can reverse PC and get conceived with that so that is the beauty wow every aspect it works through the revolving around the reducing the levels of insulin insulin right so I'm just going to summarize for the audience so basically we have to protect our insulin like our rajata yes right so that insulin my method of not eating late at night will give rest but our discretion of low c will actually make sure that the insulin is not working that much at the same time because of insulin resistance the problem is that you don't have insulin you have too much of insulin which is not working properly and your pancreas is accreting so much so when you decrease the car this insulin will go down which means that will start working again which will decrease your fat so if you have more fat the answer is not to decrease the fat the answer is to decrease the car carbs super now we understood how low carb works I'm really concerned about our kids okay as an Indian parent okay I as I have the same mentality as every other Indian parent is that anything can happen to me but if there something happens to my kid I will do everything possible to save the kid yeah correct compromising My Lifestyle so in your practice is diabetic happening much earlier than in your previous practice in the last like five years six years yeah so previously when we were doing postgraduation if a kid has diabetes it is undoubtedly it is type 1 diabetes so it is it's a different ball game type one is when there is no insulin no insulin at all it is an autoimmune condition genetic gen no it is not genetic it is autoimmune autoimmune autoimmune so due to autoimmune process suddenly One Fine Day the all the eyet cells get destroyed it could be genetic it could be other factors as well yeah autoimmune is whereas there's a triggering of immune system immune system the the your body thinks that your pancreas doesn't belong to you yeah and it starts eating up the pancreas pancreas so that is type one diabetes but sadly nowadays in kids with obesity and due to all this Rising trend of obesity we are seeing all features of metabolic syndrome in kids M so I have presented a paper in uh like recent uh state level pediatric conference okay just my analyze my 50 obese kids recently who came for Pediatric obesity management okay so when I just analyze the results I could find that around 10% already have pre-diabetes what what age group 8 years 10 years 8 to 10 8 to 10 years pre-diabetes the hbn is already 5.8 6 and I have a kid who is 5y old you won't believe she has hba1c of8 but she's type two diabetic she's obese 40 kg with full of acanthosis wow she's type 2 diabetic at 5 years no one will believe I discussed with endocrinologist she said least I have seen is 8 years type two diabetic but she's the first time even she endocrinologist see seeing a 5-year-old kid with type two diabetic what did they come to you with no just for they came for weight loss weight loss they were concerned about the same black patches black patches black patches and weight loss so when we just routinely we check the sugars and all that HBC was already ate but in our culture you know being big it's a sign of prosperity yeah right so the kid is Big we feel happy so when should the parent be aware that okay no there is some problem with this weight gain yeah so apart from the hbmc so I just want to continue the other data fatty liver the altered liver enzymes are present in 20 to 25% of the kids already fatty liver fatty liver so altered liver en liver enzymes are around 80 100 something like that then high triglycerides more than 200 250 already around same 20 to 25% so uh even even though we say obesity generally uh the regular practice is that whenever a child comes with obesity generally all the doctors check on thyroid levels they check on thyroid levels and they will say thyroid is normal or even when thyroid is abnormal they will tell okay thyroid is the hypo thyroidism is the ca for obesity and they will for thyro but actually the vi Versa it is obesity that is causing the high TSH so actually whenever a kid has obesity or whenever the so you asked about what is the marker so marker so ideally a pediatrician nowadays we check growth charts correct in growth charts there are percentile curves so whenever they fall above 95th Stile either weight for height or BMI for age there are growth charts if they fall about 90th or 95th CLE definitely we have to do all the investigation not just TSH the HBA on see the fasting insulin levels previously people were thinking that whenever a child was obese the cause was endogenous so endogenous means endocrine some syndromes genetic syndromes but statistically currently only 2% of the kids with obesity are actually genetic and endocrine causes 98% is exogenous food activity so that is why so I like the aspect you are talking interacting regularly with the kids kids correct I have seen in your videos like you go with the kids you take some selfie and say what you will do okay we won't eat after 700 p.m. so is this a good food they will say no no this is not a good fot that is actually that teaching should start early early so whenever you know before they used to show you know like a COR man like a ghost and then say you know now they're saying Dr pal is coming I let him catch you so absolutely Early Education starts at young kids but in your practice you talked about black patches and growth chart if it is more so when they come to you you what is the most common dietary mistake that they do in your practice so most common dietary mistake everyone is aware of the Obesity yes so they even since previously 5 years back when we were telling like the child is obese they will change the doctor again but now now they little bit realized that okay obesity is a problem they have come to the consensus okay obesity is a problem but the problem lies how to approach that so simply they think that okay so we can avoid junk food it will stop obesity or some people think that okay some parents think that okay she can eat whatever she wants but we should uh so she should start the kid should start doing some physical activity or get involved in a sports sports uh and the Obesity will come down so the grandparents so they say so active children when they start playing whatever they eat their gut will digest their gut will digest even the Rock and Sand know this is this is the eating agea why are you restricting now they can eat whatever they want now and then they'll figure about diab later so when I track these kids whichever kid who is 30 kg by 5 years M they by 10 years they are already 50 or 60 kg by 13 14 years they have already reached Century whether vat kohi or other people hit Century or not the children hit Century nowadays by 14 15 years wow so as the grandparents think not nothing is happening it is actually worsening worsening worsening and as say 15 years 16 years lot of type two diabetics that is alarming that's alarming even among the Pediatrics uh soed to see so you talked about avoiding junk food right is that what people do right away or what no even avoiding junk food there are two issues one thing children are very much attracted to the advertisements so uh it is very difficult for them to break those habits so that is one thing and they addicted to The Taste the sugary high sugar high salt the Masala and everything they very much addicted to the taste so if I want to uh give a dietary advice to a kid I can't say local I can't say calorie restriction to a kid obviously she can't follow correct she will just spold us what the doctor saying who is he to reduce my control and they won't follow so what I generally use physical activity in any other form is difficult so sport is good so sport they at least enjoy doing so any other physical activity is difficult for them to follow so joining a sport is important so at least they will uh follow good nutrition at least to perform better in that sport so that one thing will be there if they lose games and if they want to become fit they will at least try to follow some nutrition and among the nutrition cutting down the processed food is one angle another thing is I asked to reduce the carbed intake not like a very low carb but whenever wherever possible say for a breakfast instead of taking some roties or idly or something for breakfast I asked them to take some 40 G of nuts or some two EG two egg omelet that is more than enough correct so that is more than enough the child can go happily to school with that and nowadays the schools are having multiple break periods we used to have when we were doing school days there used to be one 10 minutes recess period that for going to toilet and come back then lunch period then again one one more res period correct now there is a snack period snack period one snack period two then lunch period and children have to compulsorily bring some snacks to them for eating in recess so every 2 hours they are loading wow and some school they say bring healthy snacks so what is healthy snacks so instead of buying in packets if they prepare in home that is healthy so homemade banana chips homemade potato chips homemade some some Leo or something it is healthy snack snack so packeted are unhealthy so the these are all healthy snacks according to the parents so this is how the choices so frequent snacking again comes back to our B initial discussion of it it spikes of the insulin spikes the insulin frequently they can eat one small low carbohydrate meal for breakfast a simple omelet will do correct then no need to take anything after no snacks at all no no need to take take snacks it's just for drinking water correct we survived without snacks it is only for going to toilet and come back you survive without snacks then lunch will be some basic food some vegetable something uh they can eat whatever lunch they want then uh after now children after coming back from school 4: they are taking another meal four oh another full carbohydrate meals we used to take three meals correct they having fourth meal so the 4:00 meal after coming back from school will be a high carbohydrate meal so during the lunch time they didn't have enough time so they were not able to eat that much so 4:00 they will come leisurely sit watch TV and eat lots of carbohydrates then again after 8:00 or 9:00 one more so there are four meals and three to four snacks wow so to consolidate the meals reduce the frequency frequency so as you said they can reduce the eating time eating window they should not eat late then as I said reduce the carbohydrate so even if the night if they want to take some chapati or Roti instead of taking three chapatis or three dosas they can take one Dosa and two egg or one plate of chicken and one chapati or one bowl of sprouts or some CH with just one DOA something like that they can reduce the cars and increase the protein a protein some good amount of paner and some something like that the reason I want to ask you was all this the kid will not follow right so you will tell the parents yeah I'll tell the parents what is the first initial response for that they will be okay they'll be okay and I tell another thing the we have to fight the conglomerates who are like they are thinking they have invested crores and they are making actually excellent advertisements to attract these kids so I have to tell the parents you have to beat those conglomerates while giving healthy foods we can't just give one POA or some ragy ball and this is healthy the kid won't eat so we have to prepare it in such way if you want to give some fruits he won't eat four pieces of Apple you make it you see YouTube you prepare on fruit custard you see some nuts dates some Buffy something like that whatever the child likes if you want to give vegetables instead of like a vegetable sub or poral you give something like like a vegetable C cutlet but shallow fried instead of deep fried some we have to do some creative thinking so that the children at the same time both they like the food but at the same time they eat healthy food also wow so we have to do these modifications in order to make the dietary intervention successful and sustainable sustainable otherwise if we just give some sub or some vegetable fry they will just throw it away on day one so parents are complaining that I don't have time to do all this right because it takes time yeah they have to do it if you love your kid you need do it you have to do it so that is no excuse for that and then you need to be creative yeah creative to be creative yeah the plate has to be colorful colorful colorful even for the smaller kids they say even one year one and half year old kid they will say they the standard complaint without saying that complaint they won't leave the OPD they say the child is not eating properly from when is the child not eating from birth then how did your child reach 10 kg or 12 kg I don't know but the child is not eating at all so this is a standard complaint they say because they force feed the problem starts from the day one they force feed they from 8 months 10 months they force feed the children and because of force feeding they don't like the food so their mind develops distraction eting so previously used to say n correct correct you see the moon say some stories and now it is mobile phone or some tablet they show some YouTube videos and whenever child is logged into the screen they just feed it correct feed it yeah yeah that's all so the children don't know to enjoy the food they don't know to chew they don't know to enjoy so they don't know how they regular traditional food North India or South India each state will have its own traditional food they won't know to taste a food so is it a simple sambar Rice some uh some Roti or some Chutney horse gram chutney with rice it's a stap food in India corre and South India correct but uh none of the children like that ah that is a problem so so for you have kids okay looking at the screen and eating if you come to us there'll be only one kid out of 100 kids who is not doing that no it's the same here also even hospitals we do see that every children every child who is admitted without looking at the screen they don't eat it all but practically speaking you have your own kits as well what do you do no it depends I'm creating problem in your family no no it's always parenting is a learning even for a pediatrician okay so paren is a great learning experience so my first kid we did all these mistakes so we want to make him somehow eat so distraction eating showing screen and all that now we are trying to reverse this mistake while bring up the second kid now he's sitting in the the table and he's eating on its own from first year first year first year of AG so some changes so if we act proactively from day one of the first year of AG instead of forceful eating we just want the children copy things from us they actually learn by imitating correct correct so what we do we eat some sambar Roy or something like that some colorful things there on our plate the children would like to have a bite from that plate instead what we do we present them present them some bland porridge and we'll be eating some colorful food you Bland porridge the children would like to eat and they will like to eat what we have in our plate and because the child is not eating that bland porridge and we do distraction eating we force Fe so that is a problem so you can sit in a table or sit on the ground then let the child have the same food like us when we eat the children will copy that but I'm going to my problem is my son Arjun he is very picky eater right so I eat broccoli he doesn't eat broccoli what is the problem how do we that's why I said we have to do some presentation something say broccoli how attractive it can be done or some taste can be aled say broccoli with cheese cheese is a good thing so add some masalah some spices spices are good antioxidant so add some spices there is no harm some spices some cheese instead of adding cheese to the the bread and take it as a pizza or sandwich we can add cheese to some vegetables and take it so when a kid says piy eater that's not true you can make him eat somehow make him eat somehow somehow like by creative ideas so I whatever I tell all the parents see every organism including an amiba has some Hunger how can an highly evolved organism like human being cannot have hunger So Hunger is there because our feeding practice is not right and the child is having picky eating okay let me ask you a practical problem so you know how do I know that okay when he says no I always say no means no starts right there that's why I so when they say no as a parent I feel like oh you know not only me everybody is that okay maybe I'm not uh is when they say no can we stop no that depends on uh how is the nutritional status of the child so we can discuss with the Patrician so when when the parent has this concern most of the parents have this concern correct so they come to us they say this complaint the child is not eating correct so we check the growth charts if the as per the growth charts If the child weight and height is appropriate appropriate then we don't need to intervene at all if he says no leave it leave it leave it simple leave it okay he's enough he doesn't need to take lunch after taking food at 9:00 a.m. he doesn't need to feel hungry at again at 12:00 p.m. or 12:30 p.m. he can take he can skip the lunch he can take in the evening after playing what's there what lunch was invented during Industrial Revolution ah so because the workers have to take timely meals they have to take some breaks and that's why breakfast lunch and dinner this timing was that otherwise they can take eat a little bit late what will happen instead of 2: p.m. if they eat at 4:00 p.m. nothing will happen so feed when the kid is hungry is it a right thing to do right thing provided the child is not under nutrition when the child is undernourished also we say feed when the child is hungry but we have to make the Food calorie dense and energy dense he can still eat less frequently let me ask you this are you seeing an undernourished kid at all uh we do see occasionally very rare so what we comically used to say previously we reading we used to see Mal nutrition correct now it is only Mal nutrition shopping next real ready Mal nutrition so that comes to the next question okay added sugar wh says 25 gam of sugar per day that's what I teach my you know my actors kid actors in my real is that 25 g of sugar per day one Mech flurry drink is 50 g g so I say that okay you know if I say don't go to McDonald people will unsubscribe my channel as well will not come to your office unsubscribe so I say split into half how how many things we can split into half it's easily more than 25 G right so what do you do in your practice so the thing is like uh one thing is for If the child wants to have some sweet something sweet let it be either fruits or dry fruits they want to have something sweet sweet is an eating sweets is an evolutionarily process so so it evolutionarily the human being uh when thinking from evolutionary process we are forced to eat sweet whenever we see sweet our mind is trained to grab that because our mind is trained such that any sweet thing is not poisonous correct that is how our genes are working so evolutionarily it is a basic basic basic requirement it is encoded in our jeans correct so we can't stop the sweet Cravings all together is actually embed inside our jeans so that is the problem so we can just change the source so what are the common sweets we take either we can add sugars to any tea coffee or some energy drink or whatever correct we can add sugars to some milkshakes or we can add sugars ice creams colas biscuits cakes correct cookies these are the items and sweets no no no no these are the added sugars yeah yeah instead of these added sugars they can take the uh sweets from the direct source from the fruits from the dry fruits here is where the creativity kicks in so the parents have have to make something like a fruit custard some nuts and dry fruit some laddo or something and it has to be palatable also so they can once they start eating it and maybe we don't buy this fully High sugari these all biscuits and cakes then slowly they will come out of the t i I even seen successful parents with too much health Consciousness they are able to restrict so if a parent is health conscious the likelihood of a kid that is where the start if the parent is is not health conscious and the parent themselves are obese or they're having eating issues they can't advise the uh child to be heal so that is a problem so it has to start from the parents only then the children will learn uh so in your practice when you let's say ask you you a kid as well okay nobody must have asked this question to you but I'm going to ask have you taken your kid to McDonald yeah you have taken have taken thank you for the honest answer it's very no so one thing uh as I said it's a peer group ah the children love to discuss yesterday I went to McDonald's I had that so I went to KFC I had that see they love to have that we have to give this little bit enjoyment to the kids we can't speak from a saint perspective so maybe but we can say once in a while as you frequently say once in a while is fine but they should have some limitation okay every first Sunday I will take you to what whatever place you want and he wants to have something from McDonald's or he wants to have something from KFC he can eat so he wants to have some sweets or something he can eat but there should be a limit say once in a month or something like that or every alternate Sundays one meal so I'm not sure how you the current Trend in us every weekend there is a birthday party every weekend Friday evening Saturday Sunday and you know the Kid birthday party kids sisters birthday party kids brothers birthday party every 3 days they are having all this pizza pass Coke and everything okay U so I say that okay birthday party a cake the cake is only on that birthday for that particular K right not for everybody is that trend is catching up over here as well yeah here it is catching up catching up so previously uh when we used to have birthdays usually we used to invite some close relatives correct or neighbors neighbors neighbors or the two even only close neighbors nowadays people have started arranging Grand birthday parties the Western culture is started started to catch up here so people are inviting all the classmates slowly the thing is picking up picking up I hope it doesn't pick up I really hope it doesn't pick up because that once that culture starts the peer pressure is going to be very hard for parents to manage so my son he says that you know apaa please be ready next weekend okay Friday evening I have this uh party make sure that I be 7:00 p.m. because I love the pizza he also knows what they no like when you said about peer pressure I want to add one thing so you said how to advise the parents so if the child has already become developed this any metabolic syndrome features little bit big on if the investigation show some fasting insulin High hbm some issues are there so if I tell the parents okay try to avoid this be strict they will say how can I be strict so we have to talk so much about the kids because you were a pediatrician yeah okay but now I want you to wear another hat where you are focusing on the parents okay my demographic is between 25 to 45 years of age where the uh we we are so confused about how to parent the K and everything at the same time we don't know ourselves in terms of how to be healthy in terms of dietary of so I want you to help us out uh in terms of Indian low carb diet correct especially for South India uh we are on Rich carb diet so when somebody comes in then says that hey no yes Dr Aron I understand I see Dr Pal's videos your videos we worship insulin but I don't know but we don't know how to reduce my car okay uh where will you start with that educating that patient okay so it first thing uh it works which whenever I see those patients uh the first thing is they have to come for Our advice uh so that is one thing when I give voluntarily advice even to my closest relatives they don't bother at all so I say you have diabetes reduce they just don't bother ask you any more advice please so they have to come to us for advice they have to like first prepare their mindset okay I'm going to get advice from doctor then second thing is uh Whenever there is a psychology uh it is actually the Fe fear which actually makes us uh follow something more correctly exactly the fear so fear of getting something bad yeah fear of getting something bad so a person comes for weight loss but we all know obesity is associated with multiple other issues so we have to document that and they have to know that it is not just to frighten them or anything so they have to document that so the person comes for weight loss I advise them to take a panel of Investigation you do hb1c you do liquid profile they say I'm healthy I'm 25 why do you need to take unnecessary blood investigations so I I just want I just want you to give some diet chart diet chart diet chart they they just don't want dietary Pro advice something diet chart it is just like a medical prescription diet chart this is your diet chart so rade diet chart tell this funny thing to me so I was taking time restricted feeding and everything so they were asking me do you have any cian rhythm chap I don't know why people I mean I was very surprised to be uh you know we have many problems in US practice as well but in Indian practice I see that why people are so fixed on diet chart no they are used to uh get advice like that so traditionally uh we go to a doctor they want some prescription some medicine they want a prescription so if a child comes to me and uh if I check everything the child is normal no need for any medication they will think why have I paid so fees to this doctor back give back just for talking 5 minutes you are charging you didn't give any medication previously they used to ask there is no injection you didn't put any injection and when we started practice luckily we didn't have to go through that trouble so the injection trouble is not there nowaday we see okay nothing is there I uh so that mentality is iMed inside so they want something some chart some five pages 10 pages some some chart explaining what explaining what they have to eat so that is one thing so before that I order a panel of Investigations as I said to find out if there are any other components of metabolic syndrome and I found that even for asymptomatic people so just they come for weight loss I found that 40% on Investigation they have pre-diabetes or diabetes so they just come for weight loss just like they go to any other nutritionist or dietitian they they asked the same question also I went to that nutritionist or dietitian they didn't advise any investigations since you are a doctor you are advising lot of blood investigation you have that connection with that lab why you writing lot of Investigation so I said okay obesity is not a simple uh cosmetic problem so obesity is more than that so obesity is metabolic syndrome you can have pre-diabetes fatty l so you should know that so once the investigations are done we will be able to find so I'm surprised and even they are also surprised to see they will just come for weight loss hbmc will be nine otherwise they would have diagnosed this diabetes another four five years after that and after whatever the diabetes has started affecting the organs after some neuropathy or retinopathy yeah eyes and they would have diagnosed it much later because uh there are no symptoms and you diagnos it little bit early we are able to find that so uh if they find the if they see those findings okay fatty liver is there so okay some pre-diabetes is there they get some fear motivation as well yeah some motivation as well fear actually helps in motivation helps in mtiv if there is no fear actually it is not unnecessary fear some fear we should have cor so why people say if you do some wrong someone will someone will punish you correct so I think the God-fearing concept is the same thing doct fearing concept yeah so but but it has to be in the right Manner and we don't frighten them with some drugs or anything we just give anyway we are going to give dietary intervention we are going to give lifestyle modification by frightening him frightening him or her I'm not going to give a truckload of medications correct so I'm not ad I'm not going to advise him to undergo some complicated procedures okay do this surgery to overcome this or do this thing so I'm just going to give lifestyle modification and they are actually okay that okay okay they have a sense of understanding okay so I've understood that it is more than obesity I have more problems and that is the main thing so after that uh we are able to get good results and whenever if they are having any issues while practically following the r as South Indian low carb diet will be entirely different we are used to eat rice cor so if a North Indian will be used to eat wheat correct in a low carb will be difficult so it is actually again based on the severity of the problem if the person is having severe diabetes high level of diabet HBC more than 8 10 or if the patient is in having infertility issues not able to conceive after 8 years or 10 years of pregnancy some severe fatty liver grade three triglyceride 600 700 so those are the candidates for a strict low carbohydrate diet so at the same time if the patient is having only obesity then some moderate some mild changes are there some pre-diabetes something so if they are not not that much motivated they need not be on a very low carbohydrate di they can follow a moderately carbohydrate di can you give me some numbers like strict low is what is your practice Yeah so strict law is the total carbohydrate content should be less than uh per day should be less than 50 or 40 G per day so the 40 or 50 g usually will come only from the vegetables and some nuts so nuts will have some 10 gram and they will just come here and there so it is not from the 40 gam is not from the grains or millets just come from them so that is actually very low carbohydrate or keto or paleo whatever name you want there are some few differences between these terminologies but basically they are the same lchf paleo keto Atkins they are all the same almost but I thought paleo keto is even more like less than 20 G also there no yeah keto is less than 20 G keto is less than 20 G and keto is more of a more therapeutic diet for more severe problems like epilepsy so even whatever the low carb diet I give is a form of ketogenic diet only the people will have urine ketones positive that is called nutritional ketosis so it is whenever we see ketosis we always fear diabetic ketosis but whenever a person is taking carbohydrates less than 50 g or 40 G even that is a form of ketogenic diet only whatever the low car diet I'm telling so it is called nutritional ketosis because the fat is burning carbohydrates are not the main source it cause nutritional ketosis so it is a form of ketogenic diet only so the terms can be used interchangeably but we need not be fanatic on avoid even vegetables we need not be that fanatic that is not necessary that even avoiding even vegetables that extreme keto is for maybe severe diseases but for most of the low carb diet we can manage with 50 to 60 G per day this is one thing moderately carb means I mean around 100 to 150 g of carb D in such a case one meal per day can be taken in the form of some grains preferably whole grain some millets any form anything is fine even if they are not able to take whole grains or millets I say even if you want to take white ray you take little bit lesser quantity just to fulfill the stomach you take add some proteins and more lots of vegetables along with it so you will have a feeling of satiety so that is enough so and other things we have to uh advise Foods whatever is available locally third category like more than 150 1 15 200 or no there's nothing like a third Cate that is the regular category no regular is isue you know I was when I was big I documented what I wrote I ate 300 G of cars per day not even I thought I was eating healthy see that is the beauty of it right so then next question is for a person even a doctor I didn't know how much amount of grams of car is there in a particular thing so you are giving a diet chat but if you what is the easier way to say okay that's a Biryani how much amount of grams of Cs in Biryani how how no the thing is in low carb obviously the concepts are simple we say avoid grains avoid grains avoid grains at all in a strict low carb di I'm not talking about the moderately carb di I will speak from a strict low carb diet or keto di something like that no no no talk about the moderate that's a more common thing okay keto is not okay oh suain okay fine so no still there are people who have been following for a severe problems like I I uh my few diabetic patients are there HBC of 13 yeah they agressive yeah a severe diabetic they are on keto for the past seven or eight years many people fear keto poo low carb your kidneys will get injured you will get heart attack nothing like that so it is just if we follow the macros and everything and we is sustainable based on the problem severity of the problem the person has if the problem uh is not severe they may not be that much motivated and they need not be the only problem is obesity they can follow a strict low carb diet for say 6 to 8 months then they can come back for a moderate diet so moderate carb diet balance that is more than enough so once the moderate carb with some time restriction then my concept and your concept everything will merge so that is one during the initial strict phase and for severe problems low car then we can come back to a moderate carb and for people with milder issues they can start from the moderate carb so for answering your question so you said how to uh how to measure Biryani or something like that so what I would say is in the moderate carb if the food contains any grains or millets simply any grains maybe rice oats wheat uh whatever grains or barley B quinoa quinoa is not exactly a cal it's some different category but still um are any millets ragi or something Jo I would say not more than one meal per day simple thing not more than one meal per day and specify the quantity whatever you want you eat specify the quantity just like you say in your videos like half portion of Biryani something like that so it will roughly translate to say maybe 200 250 g of rice half portion same the same I say 200 250 g or if you want to count say Roti chapati I would say two to three numbers simple they can just count they you not count the calories so two roties or three Roes based on the size I don't about Roy bigger than your face so so Roti yeah so Roy and something like that yeah something like that and rest of the meals I advise them to take it along with lots of vegetables veget vegetables for the fiber otherwise the 200 g of rice or that won be will not be enough either with proteins or with vegetables in either form either that thing so the other meals can be like simple nuts they need not be costlier nuts like almonds pistachios and walnuts they can be simple nuts like ground nuts they cheaper options equally good lots of mono unsaturated fatty acids they can have coconut if they are in a southern part of India where coconut is available it's a very good source of healthy fats correct if they eat non-vegetarian items they can add eggs correct non-vegetarian items any any type of meat they can have or paneer they can have in moderately carb diet we advise them to take pulses or even this soya based products and all those so these are the equally mushroom they can take so am among these whichever suits they liking they can mix it up and they can take so so one meal you said uh one meal is grain based b b that includes Roy as well you can have Roti in the morning and then rice whatever whatever be it one meal in a moderate diet in a strict diet even that is not allowed even in moderate di only one meal a day one meal a day so let me have an argument okay so when I grw up so it's like those are it in the morning that's a grain based is there will that come under grain base or yes yes yes and afternoon I have three cups of rice right one serving a sambar second is Rasa third is C and then dinner would be two roties so in your thing this is not allow right only one yeah yeah so what do we do for the other take this proteins and nuts so the concept of having Roy rice every meal should change a little bit should change a little bit either we can approach it in another way so for all the three meals we can take little bit little bit carbs and good amount of healthy fats fiber and proteins that can be done or that might be practically difficult so if we say one meal per day that is easier to follow correct they will okay this is the meal correct and this is the quantity it's simple to follow yeah rather than they can't limit with okay we will stop with one ch that is not possible especially when there's ghee on the top of it yeah so when you implement this um hunger it's a big thing and you have put a video on how to control your appetite hunger as well so when you start this you are going to feel hungry corre what is your tips and tricks for the patient no this is this is where the difference lies in a low carb diet is not equivalent to a low calorie diet in low calorie diet the problem is we are eating less we are actually starving correct basically for any weight loss there is some starvation has to be there but what we eat that matters so instead of four Roes if I eat two Roes by calculating calories I'm actually a little bit starving the body has to take the energy from the fat sources but as I said already the circulating insulin levels are high when circulating insulin levels are high the body cannot utilize the fat Source it is like say we are having some 10 CR in our bank account as fixed deposit but we have want to have one te we won't be able to utilize that money so many people will ask that question I I have people with like 130 kg 140 kg so they will ask doctor if I don't eat idly will I not feel hungry they will ask the same question I will say you have 60 kg fat 1 kg fat is 7,700 calories so that means you have almost like 4 lakh calories so 4 L calories is enough to feed you for 200 days so even 200 days you can survive with only water and electrolytes technically teally with medically body will take care of it because he has four 4 lakh calories already so we need only 2,000 calories maybe maximum per day but will take technically speaking might suffer some micronutrient that is there but technically that is right but why he is feeling hungry because he doesn't have the key to open his locker or fix deposit so the insulin is the key again so we have to reduce the insulin only then key to open the insulin box yeah which is there but not working yeah only then only if we cut down the cops what will happen is after an initial hiccup for say one week once the insulin level start coming down once the fat starts burning the appetite actually gets totally suppressed once the fat starts burning we our fixed deposit is getting converted into current account so he has 10 cres in current account he can have he can eat whatever want so that is the issue so low carb diet is not equalent to a low calorie diet so here the hunger is not an issue at all so people will be able to control their appetite very good they need not be like consciously psychologically uh suppress their hunger the food itself will take care of it so that is the concept if he eats say 300 G of meat or 200 g of paneer or 100 G of nuts he won't feel hunger for the next 6 to 8 hours many many of my patient if I eat 300 G of meat in the for dinner or say they will say I'm feeling hungry only by Next Day lunch they don't even want to take the breakfast on the next day so that much yeah protein keeps you full so that is the key here I see so H tips to control hunger is let's say initially the thought process of not eating carbs will create the hunger we should take it off yeah okay and then increase that with protein and fiber water how do you recommend with this as much as possible so water is very important so whenever they say I'm feeling hungry I will say it is not actually hunger it is actually thirst so we advise them to take lots of water that is more than enough or some soups or some black tea or black coffee without sugar something like that some soups that is more than enough so so in your thing what I'm understanding is okay so let's say you have a rice based meal for dinner yeah okay because many people dinner is the biggest meal but generally in a moderate carb right I don't advise a carb based meal for dinner the same concept so we don't want so like yeah so we don't want our insulin to get stimulated at night time if at all you want to take CS let it have it breakfast or lunch but not for dinner in lunch uh for dinner uh not eating anything as per your concept is equivalent to eating a protein meal it again doesn't stimulate the insulin at all so either taking only vegetables or taking only a healthy fat some nuts or taking only a protein meal a low car protein meal is actually equalent to not taking anything at all technically and there are even studies like even um when we always say night eating creates issues but people have studied by seeing whether a protein meal when taken at night whether it will be beneficial actually they have found that they actually help build the lean musen mass they actually help control the hunger they actually help lose weight so um most common problem the patient comes to me is that hey you know yes it's doctor fatty liver I'm not going to eat late at night let me finish my dinner 8:00 p.m. but at 12:00 I'm having so the concept what you're saying is that prot ah protein your protein is very lowow protein and fiber if you have adequate amount G and 10 G of know then that will sustain throughout you right the problem is I'm talking practically where even in us and even India as well where as a family they just made only for dinner and I think if we need to uh choose the one U carb meal I think it's going to be dinner for many people okay okay so when they're going to hospital or any office or something for lunch wise so in your concept only protein with if you're vegetarian soya tofu or something like that paner and me nonvegetarian meat and veget or egg egg or vegetabl vegetables wow this is a you're going to get a lot of questions after this [Laughter] pod because in in our mind we always thinking that okay there should be rice there should be Roy should you you should get all these questions correct yeah yeah so I've been answering all this for the past 10 years so we have the answers already rade when you in your practice people are able to accommodate yeah adopt this practice how long does it take so uh iters no it differs based on the problem and the motivation so I won't say everyone is successful but whoever is motivated are able to reverse lots of issues lots of issues like infertility fatty liver they are lots of people they are very happy the next question is that okay will you in this method okay we talk about this vegetarian is an issue when they talk to me I said increase the protein they like you know as a vegetarian I'm getting only 30 G in your practice what do you tell vegetarian for increasing the same things paner paner mushroom mushroom soya based items and even the ground nuts they contain 25 G of proteins per 100 G so and we can manage with that and if they are able to take little bit eggs that is fine still if they are able to take yeah next question is the soy H people should have asked you so much about so correct so what is your take on that no so uh actually contains some phytoestrogens so plant estrogens so the estrogen is the as we know it's a female hormone so it has some chemicals that mimic the female hormones but many times people were thinking that it contains lot of phyr that can interfere with the reproductive system in our body but Studies have shown that the amount of the f estrogens contained in soy in the quantity that we take for food is actually a little bit low and it is not that much enough to cause a hormonal disruption in the body so if you're non-vegetarian okay you have better Alternatives if you're a vegetarian you can definitely take soy it's not an issue at all and either we want or don't want I will tell one secret most of the costly infant formulas infant formulas infant say growth powders I won't say the names most of the costly you have to see the ingredients the protein is from soy soy is the readily available protein source for all preparing all the formulas so if they want to add some protein to something they will add th protein they can read this they can start reading they give a costly health drink that costs say 1,000 rupees for 500 gram of tin then they will see it contains soy powder so it is not that much uh harmful as I'm glad that you answered the question the same way that I've done a video as well I'm sorry it was a risky question I was thinking you must have if you say the other way around what would people do on my video and thankfully you said the exact same thing so the one thing I also want to add is the flavenoids yeah right so I learned in my research is that where the soy plant is being grown okay plays a role in the content of the fls FL in us it's 10 times more because of the moderate climate in India it's very low the dioxin absorption yes flavonoids impa dioxin absortion a little bit but the amount of flavonoids in India is significantly low you don't have to worry about that's what I I said so so we were talking about the soy be as a protein so the next source is fats okay and in this fats I want to ask your uh uh input on palm oil okay uh everybody is telling me that oh you should put a video on palm oil oil uh you know all this uh what do they say the refined oils refined oils or not good for you sunflower soft flower if you look at all the US Health influences they go to the grocery store and they show the sunflower oil and then they basically burn it technically right in this room right in this I also do that but at a very mild so is that is it really that bad or what does it take no so thing is even I'm seeing off late I'm seeing lots of food INF fluers even from India uh they classify a thing like it contains maida it is very dangerous it contains uh palm oil it is very dangerous so I will let's clarify a few Concepts we have to understand what it is actually it is a palm oil uh is based from the palm fruit correct so the either the pulpy portion or the seed can be used for preparing the oil so uh unless unlike other oil seeds even the fruit contains lot of fat so and the seed alone contains lot of fat so uh the generally the palm oil is prepared from the pulpy portion so uh that actually that Palm concentrate we will have unrefined palm oil correct unrefined palm oil is actually approximately 50% saturated fat 40 to 50% saturated fat which is mainly ptic acid and another 40 to 45% mono saturated fat that is the same mon unsaturated fat we say healthy olive oil healthy groundnut oil coconut oil yeah coconut oil saturated fat yeah so this olive oil everyone is saying olive oil is heart healthy olive oil extra virin olive oils contain 6 to 70% of monounsaturated fat palm oil contains the same OIC acid that is the monounsaturated fat 45% and that unrefined palm oil will be refined into two processes uh it gets converted to Palm oine uh and another fractionate so actually what we get is not palm oil so it is actually Palm that means it's not a byproduct they are dividing it so that so uh the the normal crude palm oil actually solidifies at room temperature just like coconut oil so they want to add more of monounsaturated fat that is a so-called healthy fat in this fraction that is called paline Palm so the actually whatever oil we use is not palm oil it is actually Palm so there is another uh refin it that contains more of that saturated compound that is used for making soaps for beauty products and all that and palm oil can be prepared from the kernel also the pure kernel also that that is one thing is that that we do not get in India at all that is available only in countries like Malaysia and it is actually equalent to coconut oil 80 to 90% of saturated fats but even here two things so here we if palm oil say people say it is unhealthy we have to answer two things whether whether it is due to the composition so as a said monosaturated fats actually Palm oine it has almost same concentration like groundnut oil same concentration like a sesame oil Ginger oil little bit lesser mono inated fats than the olive oil so it's a good thing saturated fats it has a little bit more saturated fat than these other oils but less saturated fat than coconut oil but what research has found that even the fear of saturated fat should go away people have found that most of the studies on saturated fat that were found to cause more atherosclerotic heart disease were based on saturated fat that are actually hydrogenated fats like vanaspati M so all the hydrogenated oils they are artificial saturated fat they are not true saturated fat they're artificially the oils are getting hydrogenated the unsaturated fats are getting hydrogenated to become saturated fat chemically so most of the studies in Us in those times 1980s were done with these artificially vanaspati hydrogenated fats so most of the studies gave the conclusion that saturated fats are heart unhealthy but like natural product like coconut oil they have other compounds like medium chain triglycerides and they have like laic acid so they have other benefits it is not just we should not view just like saturated fat is bad palm oil saturated fat is 40% coconut oil saturated fat is 92% oh it is that much heart unhealthy no it contains other compounds even though it rises LDL cholesterol to little bit higher it actually improves the HDL cholesterol also which is good cholesterol it actually decreases the triglyceride so it has multiple effects it has say liquid profile if you have three parameters it does good in two parameters in one parameter it has little bit slightly raises the LDL so overall it is actually good package even the coconut oil so that thing we so even coconate oil has 92% saturated fat palm oil has only that the Palm o has only 40% saturated fat so that shouldn't be an issue at all but the you know nowadays people are willing to adopt cocon oil because they know that okay it is minimal quantities it's good for you yeah but this palm oil concept they talk about this omega3 Omega 6 no actually this omega3 Omega 6 is the problem with the oils containing more polyunsaturated fatty acids the sunflower oil all these contain lots of Omega 6 type of polyan fatty acid which are actually pro-inflammatory but say like avocado oil or oil prepared from say walnuts they contain more omega3 fatty acids so these are actually little bit healthier versions but palm oil contains only 10% polyunsatured fatty acids even in that category it has only 40% saturated fat paline contains 45 to 50% monounsaturated fat if mon unsatured fat is healthy there is no doubt the among the medical field it is very clear fatty acid is good Pua some here and there saturated fat some Dilma is there so we'll just summarize that audience so mono unsaturated poly ands saturated and saturated mono and mono is clear good for you poly is still good but not as good as mono ands saturated fat is the debate right yeah correct even poly there are people are saying Studies have found that even though when using polyunsaturated fat the cholesterol levels comes down but actually mortality race go goes up so that is the problem so the famous studies are there like Sydney heart health study then Framingham heart study so they have uh in recent bmj British medical journal they have actually Revisited and reanalyzed the reports they found they found that the research report stopped with whether this oil usage reducing cholesterol or not but they actually compared to the mortality actually reduces cholesterol levels these refined oils poly unsted like sunflower oils but actually increases the mortality rate so operation success patient died so that is the problem with Pua mua mon no problem so regarding paline it is not that much like a villainous substance like people think just because in '90s palm oil was mainly imported even though palm oil is mainly imported the problem is people associated with it as a cheaper product substandard product was that was the case previously and from the a farmer point of view from a political point of view palm oil because of importing lots of palm oil and soybean oil uh we have from before uh 1980s before 1970s India was exporting edible oil then by 1980s India was self-sufficient now India is the number one importer of edible oil so because of using this palm oils and other oils our farmers are not growing enough ground nut coconut Sesame oils the traditional mustard oils in inside our country so it's a politically it's a problem but scientifically to a person palm oil is not that much dangerous as people believe but politically definitely it has replaced the indigenous oils from a farmer's point of view definitely it's a problem so it's a bigger question to be answered by multiple stakeholders what do the deal with the seed oils you know us Health influencers are just good do like B against seed oils so what does it take on that seed oils what you mean like sunflower H sunflower s is one of the part so the same thing this Omega 6 is being like proinflammatory most of the seed oils have poly unated fatty acids and most of them contain High Omega 6 except flax seed oil only flax seed contains more omega3 all other seed oils have high Omega 6 so as the same study I told it decreases cholesterol but increases other mortality and other is the amount matters or you know and ultimately I will tell one thing ultimately I will tell one thing whatever oil you use use a little bit little if you want to eat healthy fat eat as a whole food people even in low carb people ask me which oil to use I say you are eating nuts nuts is a wholesome package for fat you are eating egg it's a wholesome package you are eating meat PNY it's a wholesome package why do you want to add too much oil already on top of that so whatever oil you want to have eat a little bit less little bit less that two or three teaspoons whether it is coming from palm oil or whatever it is not going to make any difference absolutely true absolutely so many patients ask me the same thing that you know which is which oil is good I said how much oil do you use and they said they know for Dosa or for it have you seen I don't know how they make dosas in your house in my house we don't know whether DOA is in the O oil is in you know crispy dosa one spoon of oil is 120 calories right for mural which is a crispy Dosa we easily put three spoons okay 360 calories for one Dosa okay and when we go to restaurant what we say we want D roast right so one other thing that we can do is we can bring in fat from multiple sources right ghee olive oil butter what about ghee ghee is equally good equally even though it contains more saturated fat just like coconut oil it's the same thing so the saturated fats which were demonized like coconut oil ghee and the lard L used in Indian people may not know L yeah L is used these are actually uh not that much harmful even though they rise uh LDL to a little bit uh higher extent maybe these can be avoided in people with very high LDL cholesterol levels a subset of people say 10% might have a genetic where their LDL cholesterol is very high 180 190 those subset of people can avoid that otherwise not necessary everyone else can take every can take it yeah take it super super beautiful wonderful competion I just don't want this stop at all but I wanted to introduce to my audience about your book okay so it says RM or plate yeah okay which means that health is in a plate plate okay so this is this book is in Tamil but you know English ver is coming up as well I want you to give a concise version of what my audience can see from this book yeah so right now uh Tamil speaking or the people who can read Tamil can buy this it's available in Amazon all that so it is it was mainly as it's an article series on nutrition written for a Tamil magazine famous Tamil magazine called anandan so the Tamil viewers must be knowing it so it was a 60 part series and the main thing was to discuss nutrition not from a regular macro micro and all that from the politics if it is oil why this oil came how this from The evolutionary point of view if if you want to take about rice or millets how rice how we started eating rice if it is sugar how did Sugar entered our practice in the country if it is salt say everything from the politics to the science and the Practical and clinical aspects not just it contains this much calories it contains this much carbohy we I I don't want to give a tablet that is already there in Google that is already there in lots of apps like what does it mean to you so whether you can take or not take or in which conditions you should avoid or what are the problems discuss the controversies say like soya good or bad correct egg how many eggs you can take whether yoke is dangerous or not rice how much you can take or Millet safety like or like whether for if you are having a medical problem say like hypothyroidism whether avoiding cabbage is rarely useful or not from both the food perspective children how they can eat women how they can eat old age so multiple aspects like 60 part series and it has been published as a book beautiful so soon I will try to come out with an English version Bring up Spanish as well yeah languages so uh people please look up or or plate it's going to be in English version as well you'll put that link in the description but I really want to tell you that the amount of work that you're putting in uh I I'm hoping that everybody appreciates this because this is what every doctor should talk to a patient who walks into the your office correct unfortunately we don't have this much amount of time to spend with one particular patient so that's the goal of this podcast is that your knowledge and expertise will just translate yeah all over so you you don't get that many patients so you you have already obtained the diet chart from me the secret what to eat for morning what to eat for lunch what to eat for dinner I I got diet CH from Dr for you okay but anyway thank you so much for your it's absolutely amazing thanks for inviting I actually I didn't notice the time at all and it was wonderful having a lively conversation with you super something tells me that this is not the first time yeah yeah we will meet soon thank you thank you thank you thank you