Transcript for:
Liver Health and Diabetes Insights

If a person loses weight and becomes underweight, the chances that diabetes and the medications will go away is about 80%. In one of your talks, you said one in three Indians has fatty liver. Yes.

In Delhi, it could have maybe one in two. Delhi people don't walk much. They have a car, a bus, a metro service. And there's not much space to walk.

There's no space. Can taking too much paracetamol damage your liver? Today, the most common cause of liver failure in the US is In London, Paracetamol is poisonous.

Conversion from sugar to fat is there in the liver. More and more calories, more and more fat. And this fat in the liver should be less than 5%. Suppose, the liver should be 1500 gm. And you have more than 5% means, if there is 150 gm fat, it's a fatty liver.

How long does it take for a fatty liver to... become a diabetes situation? That's a difficult question.

It can be a chicken and egg. But generally, almost all diabetics will have fatty liver. The WHO says, not me, that alcohol in no form, in any amount is acceptable.

But why is it so? Because alcohol is absorbed from the stomach. Rest of the food is absorbed from the intestines.

And within no time, it goes to the liver. And singularly liver is affected with alcohol in no time. Fatty liver leads to insulin resistance, type 2 diabetes. 77 million Indians above the age of 18 have type 2 diabetes. When should you get medical intervention done?

Today my guest is Dr. S.K. Sareen, renowned gastroenterologist and author of Own Your Body, A Doctor's Life-Saving Tips. Dr. Sareen, thank you so much for spending time with us, to talk to us. We have a number of questions. Shalini, my colleague, is with me.

And for viewers and listeners, do buy this book. It's a kunji, as Shalini says, for understanding your body and to see the signs. I will allow Dr. Sareen to speak about it and how this book can help you. So it's something that can be read by people of all age groups. You don't have to be somebody who has an ailment to read this.

In fact, it should be read by people to prevent ailments from taking place, to see the signs of where your body is showing signs and symptoms, which you should not be alarmed, but take caution. But Dr. Saab, I will ask you to explain the book later in the podcast. But first, let me begin with one question that I first thought when we were talking about liver.

My first question was, why do we say lily-livered person? Why did that term come? Why did that come?

Because people knew about liver so early. So why was that? Do you believe in horoscope?

No. Horoscope? No. No? No.

The word horoscope actually comes from hepatoscopy or heriospicy. Heriospicy is a Greek way. Heriospicy was the science by which people could predict Looking at liver, what is going to happen? Will the king win or will the king lose?

This is in the Eutrasian, Babylonian times, much before the Christ. There was no God or, you know, thing in the temple. It was the liver. Means, liver is removed. Liver, animal's liver would be like, you know, you can take out and say, oh, this liver is good.

Means, it is having robustness. So people used to pray liver or the models of liver or the stone carved liver in the temples. So liver was the main organ. Nobody knew heart.

Heart only came to be known in 400 years ago. So jigar, liver was the main organ of the body and it has been worshipped. Lily liver was called when there is a coward. You know, coward's liver is a lily liver. Like a soft.

Soft. Now it's not soft. It is actually very friable. Okay.

Very friable. It's not soft. A soft liver is not bad.

But, you know, animals are fed on fig. There's a little fat liver. There's a fat animal.

That was a fatty liver. That was not a very healthy liver. So, this piece of liver, that's another one which you said. Why a piece of liver? Because liver was the main source of your energy.

You know, you can say that the glow on my face, the liver. So, even if a friend was made, for that. People say that there is a Jigar, there is a Jigar Muradabadi too.

That's true, I forgot. So, those of you who don't know how Jigar Muradabadi is related to current... Writer, lyricist, do see that. I'm not going to tell you. Do Google and see how Jigar Muradabadi, what is his connection to poetry, to Indian film industry.

I'll leave that to you. Yes, tell me. It was so important in those days that your health, your fight, like who got the fire to mankind? It was an accident, wasn't it? No, it is Prometheus, the Greek God.

Yeah, Prometheus. The Greek God got the fire for mankind. That's why people started getting fire. But he was punished. by other gods.

So, they put a crow on it who would nibble out the liver in the day. But the crow, the vulture would sleep in the night and the liver would grow up. Regenerate. Regenerate. So, every day, the vulture would nibble at the liver but liver has the capacity to regenerate.

So, his punishment... Actually could be in a way shelved by the night's rest. What does it mean? Your liver regenerates in light. If you are having a good liver, a healthy liver, let it rest in the night and it will regenerate.

Like your hair. the liver can regenerate so liver was so important the maximum punishment given that is the god's did for prometheus but he survived okay so now that we've gone into the history of it um there's one quote uh doc in many interviews we have said that liver is the soul and the boss of the body yes so explain to me why is it the soul and boss of our body? Soul, in many countries, liver is actually symbol of love.

Oh? Symbol of love. In Mexico, there is something called as a mango square.

Okay. In the mango square, there are mango trees. So I went there once and the tour guide said, Sir, this is Mango Square. I said, so what?

It's a Mango Square. He says, no, sir. If a girl loves a boy, she will say, you are my mango. And if a boy loves a girl, he will say, you are my mango. So I said, but how does it make a difference?

He says, whatever is the best thing. And Mexicans love food the best. I said well that's a good thing but how does it connect to liver? Having fruits like mangoes are not bad you know like it's a mango season.

Sure. But gaining weight I said then what do the girl and boy do? Keep running. Keep running. So the mango square if you give your girl and they will you can't get a girl easily good girl you keep running.

So I said why have you called this as a mango square if you love someone you run around and you get what you like. You say I get. my love to you, but to get that, so eating and keeping your liver and health was very important.

That was the Mexico message for me. Now it is the soul, it is definitely the soul of life. All your material, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your life, all your Metabolic factories, all your iron, your sugar, your fats, they are all metabolized by liver. You know that your sugar is controlled by? Yeah.

Pancreas or liver? Pancreas. Since I am a liver guy, you say liver.

I will say pancreas simply because I would say that insulin comes from there. But then I know the connection, but you tell me. See, whatever the demand liver puts, the pancreas makes it.

So suppose your liver has fat. the insulin doesn't get into the cells. And if insulin doesn't get into the cell, you need more insulin for the same work. But double work has to be done. The pancreas has to make more insulin and more insulin.

And over a period of time, if there is fat in the liver, then pancreas gets... exhausted and you get diabetes. This is one of our major messages that if you have fat in the liver, it's not a good liver and you may have diabetes over a period of time.

If you don't want diabetes, do you anyone want? wants diabetes no no yeah you don't need any other disease if you have diabetes then your heart your everything gets connected with that but um i need to know about how what are the signs and symptoms about fatty liver disease see it is too simplistic okay actually everything you know take is converted to sugar, to glucose, to be utilized. You will eat protein, you will eat nuts, everything has to be converted to sugar. And that sugar is the main fuel for your energy, for your body.

Now if you have sugar, it goes to two places mainly. It goes to liver, you ate, ate pakoras, ate sweets, all that got absorbed and went to the liver. And in the liver it is converted into sugar. But it also goes into your muscles. If your muscles are not there, all the glucose now goes to the liver.

So the liver has excess glucose unless you are using your muscles. And you need this much glucose. But you have taken so much.

Right. Two ice cream. Yes. So all those calories went into your liver.

And it is deposited in the bank as fat. So conversion from sugar to fat is there in the liver. So more and more calories, more and more fat. And this fat in the liver should be less than 5%.

Suppose 1500 grams of liver should be there. And you have more than 5%. Means 150 grams.

If it is fat, it's a fatty liver. So now the definition is clear. Less than 5% is a healthy liver of the total weight.

If it is more than 10%, it is a fatty liver. If it is more than 30%, it's grade 2. And beyond 50-60%, it is grade 3 fatty liver. It's very advanced fatty liver. And fat in the liver is extremely harmful.

You said diabetes is there, there is no need for anything else. But fatty liver... So that story starts from there. Okay.

How long does it take for a person to realize? Is it a silent thing? It is a silent thing.

It is silent. You don't know that. Liver is a very sturdy organ. It doesn't make any sound until you don't push it.

If you put so much weight on it that it sits like a truck's stuff, if you put it in a car, it will push. If your liver is under so much pressure, if you put so much extra weight or calories, then the poor liver will… Slowly get fibroids, it will become hard. It won't work. So how long does it take for a fatty liver to become a diabetes situation?

That's a difficult question. It can be a chicken and egg. But generally, almost all diabetics will have fatty liver. You asked me how I know that my liver is fat.

So first I will tell you that and then its journey. So anybody who is overweight. Overweight comes. means?

Obese. There is a difference between overweight and obese. Yes. Overweight, chronic obesity. BMI is little higher.

Yes, BMI is between 23 to 25 for Asians is overweight. Above 25 is obese. Westerners say BMI, body mass index is above 30. But for Indians, for Asians, it is very low.

Secondly, if someone at home or you have diabetes, blood pressure, high cholesterol, or cancer, or kidney disease, stroke, all these liver have fat. So who has fatty liver? Those who have one or more of these CBAs. Now see its journey.

Which you say that in one of your talks you said one in three Indians. One in three Indians. Has fatty liver.

Yes. In Delhi could have maybe one in two. Delhi people don't walk that much. They have a car, a bus, such a good metro service. And there's not much space to walk.

Right. And they take it very lightly, ma'am. I have fatty liver.

Normal, very common. Fatty liver, the doctor said. Still having chole bhature and all. And he said, we eat and drink at home. We eat and drink at home.

So fatty liver is there. Absolutely. Good.

We are Punjabis. If Punjabi doesn't have fatty liver, what will happen? It's seen as a matter of, I mean, a joke or a pride or whatever you want to call it.

Or a defense mechanism. That we can't do anything now. Now fatty liver is done.

It's done. So tell us the journey that you were talking about. So the journey is once the liver has this extra insulin requirement, then slowly diabetes occurs.

Now this fat from the liver is actually spills in the blood. Up cholesterol. cholesterol triglycerides fat triglycerides 3 fatty acids cholesterol simple high lipids where did it come from that spills from the liver excessive production from the Liver is filled now it has gone to the blood. So, the person who has high cholesterol The one who has high triglyceride, has fat in the liver.

So, diagnosis is done, no need to come forward. Then that cholesterol or fat is like circulating all the time. At night and day, it will accumulate.

In your arteries, arteries become hard. If the arteries are hard, you get blood pressure, heart disease, stroke and all cancers. Now, we can make it a little interesting.

You may say that I used to run a lot, I used to exercise a lot, but still my weight doesn't decrease. It is quite common that people say, how can I reduce my weight? So today a study has come in JAMA, a very famous journal of our world. It is published today and I thought I must share with you. Published today.

In that, obesity is heritable. You are Punjabi, right? My mother was also fat, my father also ate and drank well.

So when I had a child, he also became fat. So if both the parents are overweight, then the child becomes fat. is 77% This is very important. Both the parents are thin. So the child will be overweight.

Its chance is 3%. So this is in inheritance. Genetic dispensation.

It is going to happen. So what does this mean? If your Maruti is getting spoiled then will you run the factory or close it?

If Maruti is getting spoiled then will the production close? that its handle is not right, its brake is not right, so why will you make a car? So, we can't eliminate Punjabis, sir. I was trying to explain the same thing.

What will you do? I am saying this, that till the time this whole study carries, that when a 17-year-old child is there, from that time, and exactly this is what I had written in this book, but today, there is a second verification of that. That? If you stay thin, your child will be healthy for 10 years.

If you stay fat, there is no need to continue the production line. Wait! Why?

I will give you another example. Have you understood it? Yes, I've got it.

So, a couple has to be first healthy before giving birth to a child. Absolutely. To a healthy child.

Absolutely. Otherwise, don't produce. Okay.

If you live in Delhi, you say every day that the air is very bad. Pollution is increasing My lungs have been damaged for 15 years Look at that child who is in the womb for 9 months He also has pollution If excessive calories parents are found, then the child is born How will you face that child when he grows up that I produced you When I was not healthy So the first message from my side is Do not produce unless you are healthy Number two, children are not healthy They don't know what to eat. He is 15 years old.

You live in Delhi's pollution for 15 years. You are very sad. That child is overfed for 15 years. He doesn't know what to eat.

So why are we polluting a child by making the child obese? So for Punjabis and for all people. Not for Punjabis. Please remember that neither be overweight.

And not produce a child. And do not make a child obese. Childhood obesity.

is one of the worst things which will come. And in Delhi, we did a survey of college students aged 18 to 25 years old. To our painful surprise, only 30 or 27% had normal waist.

70% girls and boys had not normal waist. Their waist was more. Do you have any idea how much should be the waist of a female?

It should be sir 28. This is what I believe. 80 cm. 80 centimeters for a female and 90 centimeters for a male.

Dr. when I was in college, now I'm talking about like the 80s, right? I remember just one or two people among all of us. who were, who was like, mildly overweight. Everybody was thin.

And today when I look at, today when I look at people in college, they're not. You can even see old newspapers. When you see older newspapers, everybody looks thin in that. Yes. And now it is not true.

And you can imagine what will happen to the next generation. So this is one of the major messages of Own your body. Own your body or the fact that do not go to doctors but learn this single fact that a person Should have a girl should have a waist of 80 and a man should have a waist of 90 because central obesity for our people Whatever obesity is and that is reflected in fatty liver or in all your metabolic ailments so people Let me tell you one more good thing.

We say that the air is very polluted here What about food? There are indices of what we call as diet inflammatory index. Okay. Diet inflammatory index is the food. And foods are, you say I have food allergy.

I am allergic to wheat, I am allergic to gluten. I cannot take it. But have you ever thought that it is an inflammatory food? Have you thought of an inflammatory food?

What is an inflammatory food? Yeah. Yeah. If you take air, it pollutes the lungs. Lungs get polluted.

Similarly, inflammatory foods are a major problem. And the major inflammatory food is sugar. Okay.

Fructose. Hmm. So, why the obesity is increasing?

Why in our colleges having a coke, having a fruit juice, all these have fructose and the fructose is the major cause of fatty liver. An American boy in one year takes close to 24 kilograms of fructose. He will drink so much coke, take so many sodas, fructose in everything. But even in India it's there now.

In India it's also there. what 40-50 years ago people used to talk about American foods being meetha. It's in Indian restaurants too.

In India, we used to drink Jaljeera. You know, you took a lot of lemon juice. There was no corn syrup. There was no fructose added into that.

And so that is an inflammatory food. So today, foods are categorized on Diet Inflammatory Index. And the most important inflammatory thing is your Sugar.

Sir, I just wanted to know one thing that people used to say, that the one who drinks, who takes alcohol, right? Yes, sir. Sometimes it happens that a non-alcoholic person is told that he has a liver problem, that he didn't do it. What can be the reason behind it? Okay, I will ask you a question.

Yes, sir. How many people drink from the media? It's difficult to say.

We have this bad reputation. I think it's a good question. Reputation. But sir, I'm sorry. No, he says that they think a lot.

They are artists. They are media people. They are creative people. There is a myth. There is a myth.

There is a lot of stress. I don't understand. I don't drink.

The first, therefore, the message is to media people and to everyone. And you asked a very right question. Alcohol is a socially accepted poison.

The most socially accepted poison. Everyone agrees to it, even if they drink it. It's poison, that's for sure. Do you agree?

So now, how do people understand what are the harmful effects? So many times people say, Sir, I drink it, nothing happens to me. The other one also drinks it. but everybody's body is susceptible to alcohol in a different form. And that is a reason of genetics and the bacteria that you have in your intestine.

bacteria they get used to alcohol and may not like alcohol there are two types of bacteria and then you get liver disease so alcohol is a poison in that manner and we do not recommend it in any form then what about doctors who say that drink one or two glasses of wine then it is fine you always will find doctors and you will always find lawyers and you will like always find media people who are different but this is science the who says not me Sir, alcohol in no form, in any amount is acceptable. But why is it so? Because alcohol is absorbed from the stomach. Rest of the food is absorbed by the intestine. Alcohol is 100% absorbed from the stomach and within no time it goes to the liver.

Singularly, liver is affected with alcohol in no time. People say, eat fat along with it. If you eat good heavy food, then alcohol does not damage the liver. It doubles. Karela and neem chada, both work.

Heavy food, fat itself is bad for liver. And then you take alcohol. Does it affect the liver in different ways?

ways like alcohol in a different manner and fat in a different manner. Yes, yes, yes. Alcohol in a very different manner. Okay. People think alcohol doesn't have calories.

How many calories does sugar have? Tell me. One gram sugar. At least 4 calories. And alcohol had 7 calories.

Nearly double. So alcohol gives you, fat gives you 9 calories per gram. So if you took alcohol, suppose 40 grams, 50 grams. So how many calories did you have? 350. Then you took fat with that.

So one dinner of yours was 1500 calories. Which is your whole days, maybe not even whole days, more than a day's. Exactly. requirement so adding alcohol and adding fat makes things doubly worse so alcohol se bhi liver damage hota hai fat se bhi hota hai and then inactivity pite gaye sote gaye pite gaye sote gaye so somebody who has a liver damage and is a non-alcoholic meh toh pita hi nahi tha fir meri liver kaise damage hogi that's another thing that i've heard how can she have oh she must be a closet drinker that's why her liver is damaged she That she's 150 kilos is a different matter. Nobody thinks that.

But the point is that she's such a God-fearing soul, vegetarian, non-alcoholic. Then how did the liver get damaged? So tell us.

This is the fact I told you, the liver weight. If your weight is more, then you have more of fat in the liver. And that slowly, slowly, the fat is...

Not healthy for liver but not healthy for rest of the body. So fat has two effects. One is liver damage and the other is rest of the body. So if you lose that fat, you have blood pressure, you have heart disease, your gallbladder... But liver itself gets shrunken.

Liver gets scarred. If your hand burns, it will become scar. If liver gets fat, it will become scarred. fatty liver becomes fibrosed, hard liver, then it becomes cirrhosis of the liver.

It is the commonest cause today. Before we ask more questions, I am going to bring this true and false. Doctor sir, tell me this, does drinking black coffee help protect your liver, true or false? Yes, true.

It protects. Yes. Okay, the next one is… But why are you asking?

You all take coffee or tea? See this, sir. Coffee? Coffee.

So, it's working for me. It's working for me. Is moderate alcohol...

What do the other people, like the cameraman, take? Coffee or... Coffee or tea?

Plagg coffee. Pick up the coffee and the tea. Oh, we've got all of them.

Yes. Thanks. Is moderate alcohol consumption safe? No, you're asking the wrong person. My answer is...

It is not safe. Not safe. Okay.

Next. In your country, no one drinks in ANI. No, of course, they drink. No, no, no.

Here, no one does. And the ones who drink there, they won't say. They won't tell. They look better than their face.

Sir, they are looking here and there. They are going under the camera. Okay.

Can taking too much paracetamol damage your liver? Yes. Yes.

Really? Yes. After COVID, paracetamol... It's not a good idea.

Glutathione is some substance in the liver which protects the liver. Okay. So if I am drinking, glutathione reduces. Paracetamol is needed to break down, to neutralize glutathione.

Okay. So if you are a fat person, glutathione is less. If you are drinking, glutathione is less.

And then the capacity of the body is how much paracetamol I should take. So today liver… failure ka sabse common cause US mein London mein is paracetamol poisoning which is also pain killers so never take more than 2 or 3 tablets agar leni bhi ho to adi adi goli karke din mein 3-4 bar lein jyada na lein next one does exercise have no impact on liver health yeh kisne likha hai yeh to theek nahi likha does exercise have an impact yes of course it has It has an impact on liver health. This is all written by the gold diggers.

Couch potatoes. And he's in fact one of the thinnest in our team, I think. Yeah, there he is.

Well maintained. He's very careful about his diet. But does it have an impact?

Is it? Yes, it has a good impact. And we can discuss it later or whenever you want.

Okay, so it has a good impact. So it's this thing of I keep exercising, which you said. And despite that.

So what it does is the muscles. of your body, they release myokines. These are communicators from muscle to rest of the body.

Myokines regenerate liver, it regenerates your heart and everything else. Should I tell you a very interesting experiment? So an experiment was done.

on mouse. So they took obese mouse and they took thin mouse and they made the mice exercise, running wala, unse khub unse exercise karai. Aur obese mouse jo the wo toh daudte nahi the.

They used to study. So, they took out their myokines from the thin mouth and gave it to the obese. They started moving around. Oh. So, the fact is, these things which are produced by excess.

Exercise are many many new things. Two things already known. One is endorphin. Endorphins.

Yeah. So you get a good. Feel good.

It's a happy hormone. Then you also have with exercise. Many other good things like.

Production of lactic acid. Which burns your stuff. Which is also very good.

And then the myokines. And exercise. What does exercise mean? I have told it a few times in my suggestions.

Shalini exercise. Exercise. Sir, this is you know, it is all about fitness, you know, more exercise, exercises, you know, moving your body, moving your muscles, workout.

What kind of exercise is this? Exercise. There are no steps. Exercise means once you start sweating, plus 45 minutes, before that, everything is warm up. You walked and came, you didn't sweat at all, sir.

So that is not an exercise. So what about yoga? Well, we'll go into it. So exercise means once you start sweating, means your body level, your heart rate has reached that level. Cardiola.

More blood pumping and all. And then only it is an exercise. And it should be 45 minutes after that. And normally we say metabolic equivalent, which is met testing. So how much exercise can we do?

There are 2-3 simple methods. One is a talk test. That you are exercising but you are not able to speak. You are doing this level of exercise that you are breathless. I can't complete.

What is your name? Sir, my name is... Which is a stress test because they time, you can do it till one level and after that it doesn't work. So this is a good level of...

vigorous exercise which should be done and other than that how much time you take for bike how much time you do this running. It has all the methods but fundamental is that exercise is good for liver and of course very good for body. Okay. And for your bones.

So how do we know that our metabolic health is good or bad? I am deviating from this but how do we know? That's a very good question.

Metabolic health is not a good measure but your ability to exercise is a good measure of your health. For example, you should always keep your bone. Bone is your best regenerative organ.

So be younger than your age as far as your bones are concerned suppose you are 30 your bone age should be 25 suppose you are 60 your bone age should be 50 so if you keep your bones and invest in your bones you remain healthy and for women who are at a postmenopausal level also should so the bone formation and bone bank is up to 29 years of age after that slowly slowly bone decay muscles start decaying after 50 but bones after 29 so in the younger age if If you have children or your friends, make sure that they invest and gain more bones, more stronger bones than when they become old. Obese children get more fractures. Their bones are weaker. Bones get brittle.

Brittle bones in overweight and obese children. So the children should be taught to remain healthy, active and their bones should be stronger. So metabolic health parameters are by blood pressure. is okay and now look at this 90 by 60 is a BP low go low no it's a good blood pressure it's not 120 by 120 by 80 is a standard adult but if you have 100 by 60 you're quite lucky okay About 30% of Indians by the age of 30 have hypertension.

They are 30 years old. So we need to tell them that blood pressure is low. So metabolic health is an important part. That your BP is normal, 100, 110. And you get a good sleep. And then you feel happy.

Every day is a good day for you. if you sleep well which is the other myth that we have does fatty liver worsen your diabetes I think of course we've already talked that yes predisposes predates yeah it predates diabetes so before we come to type 2 we've already talked about it got fatty liver. Does intermittent fasting damage your liver? This is a good question.

This is important. Does it? And this is very much in ma'am.

Intermittent fasting? Very much in. Intermittent fasting is a very western concept i would say time restricted eating is a better concept intermittent fasting means that's not a great idea in fact it can increase your cardiac problems and other problems so clearly time restricted eating means that was all the that's an indian concept Indian, Jewish, Muslim, all of them, nobody would eat after 6 or 7. But journalists start work in the evening.

They start work after eating. When you do night duty, don't keep nibbling. That's a very important advice.

You have finished, after sunrise, eat. Before sunset, eat. So basically, I mean, like there are also, you know, people who live in cold climates. So for them too.

8 hours or 10 hours is what you're saying I would say 12 hours 12 hours It's a good amount of 10 to 12 hours of fasting it is good fasting always increases your longevity it's the best tip for longevity okay okay so that's one is non-alcoholic fatty liver disease becoming more common in india true true yes and the next generation will have more and the next will have more because we have genes now the indians have now got the fatty liver genes and they don't move that much unless through your this podcast the country may We don't want to make a decision. You just have to decide. I don't want fatty liver. You will not.

So if somebody already has a fatty liver, is there any way to prevent? Of course. Not prevent. Regress.

Regress. Fatty liver can be regressed. It definitely can be regressed.

So if you have your height minus 100 is a simple formula. If your height is 150, then take out 100 from that. Your weight is 50. But if you're...

your parents have diabetes blood pressure or you yourself have it then means 150 centimeter lady should have weight of 45 kg and for men it is also true so remember being underweight is better for simple inches so in this case 5 feet man should have 100 pounds every one inch is 6 pounds and if it's a woman then 90 pounds for 5 feet every 1 inch is 5 90 pounds for 5 feet every 1 inch is 5 pounds suppose a girl is 5 feet 6 inches, the weight will be 120 pounds so viewers and listeners, if somebody tells you you have become very weak, weak is good weak is good lean and fit is better don't say weak but lean and fit and fit. Humara wo alag hai, right? Somebody's fat, the polite way of saying aap bade healthy ho gaya ho.

Do you understand? I understand. Bilkul nahi kata hai, aap bhi thoda achcha lag raha hai, healthy hai. Healthy hai. And what is actually is that it's a detrimental thing.

It's a detrimental thing. Absolutely detrimental. Every one kilogram extra after the age of 50 decreases your age by one year.

Suppose you are 60 and you are 20 kg overweight and you want to live longer, every 1 kg reduction in weight will add 1 year to your life. Right. So that should be an incentive. It's an incentive.

It's a clear science on this. Yeah. Absolutely.

Herbal supplements are always safe for liver health. True or false? False.

Yeah. False. Why? What is herbal supplements?

Supplement means capsules, tablets. So if I'm not eating vegetarian food, I'm eating a pizza, after that take herbal supplement, everything will be fine. I'm doing wrong, right? Yeah, absolutely doing wrong. So tell me why I'm doing it wrong.

Because you have to have food in a natural form. You know, like we live, plants are also alive. They are living, you know, things.

So if you want to eat something which is beneficial for you, You eat fresh carrot, radish, you know. Not in juice form. Not in juice form. Number one. Number two, having herbal supplements.

Supplements are needed for those who don't want to eat normal things. If you want to live long and you want to live healthy, 50% to 60% of your food is fresh uncooked and natural but what people do is ultra processed yeah they use ultra processed and their 95 percent food is just for the tongue yeah so we had a michelin star chef who came out here and said it is a lazy mother aunt father whoever is cooking in your house because i these days Even men are cooking in the house. So it's a lazy person who says, the bache khaate nahi hai what I make.

It's simply because you're not involving them in the cooking process and you're not presenting it in an attractive manner. Present it in an attractive manner because a lot of it is in the mind. So all of us have to make that effort because it's good.

for our health and our children's health. Absolutely. Absolutely on the dot, Svendaji. This is absolutely correct.

Children should be involved in the finding out what is good for me and what is bad for me. Usse kaiti na kya achhaya jhoot bolna. health is a family business is the top priority in the family and the head of the family the lady should lead it head of the family is lady she should say first monday or first sunday or third sunday health is never discussed.

Only illness is discussed. Correct. Bimaar ho gaya hospital jaana hai.

Usko dawai laani hai. But do we ever discuss that how can we be more healthy? How many miles have you gone for bike? How many laps have you swum? Koi nahi pushta.

So let health be a family business and it should be mandatory and the youngest of the family. Chote bache se gana, abhi tu ne number dene. Mami ne kitti daur lagai, mami ne kitti seedyan chidi, mami ne kaisa khana khilaya, kitna healthy khana khilaya.

Right. Get the children involved. Get the children involved and educate them on what is most important is health education.

And it's collective benefit for the family. True. Sir, I read somewhere ki jab bache dinner kare ya fir kuch bhi khana khaye.

they should not watch television or mobile phone because the energy which you will get from the food it is going to be get distracted how much it is absolutely true you should know what you're eating When you are driving, you know, which road are we going on, which gas station will come, where do we have to take what, if we are going to the temple, then we know the way. If we are eating, we don't know what we are eating. You are watching the cricket match in front of you.

For today. Mindless eating. Mindless eating. We must realize what we are eating, why we are eating, and also, it will give you energy.

So you are absolutely right. When you eat, you try and focus on the type of food, the quality of food, the content, the nutritious value of the food, it is your fuel. You fill the best petrol, you take the best diesel, why don't you have the best food for you?

Find out, eat that. Sir, liver transplant in private hospitals costs around more than 40 lakhs. But in ILBS, it is below 20 as much as. Now, if someone wants to get a liver transplant.

So, where did we come from? Transplant is our... We have to do this first.

Mindset. True. Before we come to the disease.

The fatty liver requires a mind transplant. You have to change your thinking. Like if there is a fire in your room, what will you do first?

You will take a fire extinguisher. You will put out the fire. Fatty liver is an alarm for rest of the illnesses.

The alarm is, tomorrow there may be diabetes. Tomorrow there may be blood pressure. Tomorrow there may be pancreas. problem ho sakte hai.

Gallbladder ke stone ho sakte hai. All cancers, all. Breast cancer, prostate cancer, colon cancers, they all come through inflammation.

And what makes inflammation? Is fatty liver. So the first thing is don't ignore fatty liver. It's an alarm.

It's a fire alarm. Listen to it, extinguish it, get rid of it. After covid lot of people are going through this liver cirrhosis why it is happening sir? It's not after covid it's always been there.

And I think it has been there for almost two decades now. But the ratio has been increased, sir. No, I wouldn't say because of COVID.

But maybe people have gone for health check-up after COVID and they have been found to have. Now, like people have gallbladder, gallstone. Small children of 10 years, 12 years, they also have gallbladder stone. But why is it?

Because it tells you that you have fat in the liver which deposits in the gallbladder, so you get gallstone. So gallstone is a liver disease. The gallbladder is situated like a spleen. Close to the liver. No, no, spleen is on this side.

But gallbladder is part of the liver in a way. So stone in the gallbladder should make you worry. My liver is fat, gallbladder has stones in it. Tomorrow I may get blood pressure.

5 to 10 years later. diabetes so this is the message that should be clear that all metabolic illnesses start from liver all non-communicable disease start from liver so i also want to ask you about hepatitis how many different types are there inoculations it's that These we have not been inoculated against, what should we guard against? How?

We are going on to a different playground. But it's your zone. No, my zone.

But I would like first to in a way communicate to people about the few of the other things related to fatty liver and then we come to the hepatitis. Absolutely. So, for example, people would like to know that if I have fatty liver, how can I be fine? Okay. So, one thing was you asked me was about the weight loss.

Second was about exercise. Third is what should I eat and I said that diet inflammatory index should be low. That means diet should not have inflammation and sugar level should be low.

One of the things which is important and is game changer is the use of millets. Not because the country is having the year of the millet, but millets are low glycemic food. What is a low glycemic food?

The food which increases the sugar slowly and lessens it. You ate sugar, the sugar increased quickly. That's why it is said not to take sugar.

So in low glycemic foods, millets are very important. important, it does not let your sugar level rise and you do not get food allergies. All the gluten, wheat allergies. So I strongly recommend people should try and change to Jowar, Bajra, Ragi and all that. The Shree Anu which is now being called.

It's a very important thing. The next thing is how do I get rid of fatty liver is to have a good restorative sleep. You will say, what is the relation between sleep and obesity?

So people who do not sleep, let's say, are sleeping one hour less or half an hour less, they get obese. What does less mean? Normal restorative sleep is seven hours. That will be in the next birth, sir. No, no, in the same birth.

You decide your priorities. I want to live, be happy, be healthy. Those whose sleep increases by 18 minutes a day, their life increases.

These are all science facts. 18 minutes. Those children who are less than 12, but they have slept less than 9 hours, they become obese.

So obesity is directly related to the sleep. Ok kids, from 2 pm to night, you sleep. Those children who sleep between 2 and 6, and those who sleep between 8 and 10, obesity is multiple times more in those who sleep late. They come, work or go out, then come, eat, then they will get obese and they are absolutely unhealthy.

Because what you eat is eaten by your bacteria. It's not eaten by you. You eat, your intestine bacteria process it, then it goes into the body. So if you eat late, then bacteria keep on working till one hour, two hour more.

And you don't get a good health. So very... important message is therefore after sunset, you ate more or less at 8 o'clock, don't eat after that.

Try to eat earlier than that. And those who eat late will become obese. Then, so how do you decrease obesity or fatty liver? Is by having a timely sleep and timely food.

Then, extremely important for us is what to eat and how much to eat. So how much to eat is you don't eat the whole dinner plate. Start with desert plate.

Okay, good idea. Keep half of your stomach empty. So what we do is, the stomach is filled up to here.

Sir, I have acidity. Oh, you have to have acidity. You have filled up the stomach acid so much, instead of going down, the acid came up. Reflux.

So the reflux is because you have eaten so much that the food now, acid has to be there to break down the food. So eat half of what your capacity is. Capacity is. And slowly, slowly, Try and decrease your capacity of eating. So, if I am eating two rotis, then I should do one and a half and then one.

Absolutely. So, the next thing now is how much to eat. Start from a dessert plate and keep your stomach half empty.

And... What to eat? That is important.

What to eat? I told you millets, but I will say naturals and the colored vegetables are the best things. Okay.

Please do not use things which has high sugar. For example, apple is a good... thing you know but if you start having all those very sugary fruits they are not going to help us so portion size portion size certainly but portion size of sugary things which we can't avoid in the sense fruit Fruit is also sugar only. Yeah, yeah.

If you want to eat a fruit, you can eat a watermelon. You can eat a mango. You can eat a mango. You can eat a mango. You can eat a mango.

You can eat a mango. You can eat a mango. WHO recommends that you can take 10% of the calories you need. So, 10% sugar is now applied to 5% of the body.

For that means, you have taken 5 oranges in a day. 5 oranges means all your sugar requirement is over. You can't have any sugar.

in anything. So remember sugar and that leads to your high uric acid. If you have a lot of fructose, you get high uric acid.

People say that they have protein, they have gout, uric acid. Uric acid is produced by liver and by fructose. So the next message is have colored vegetables and fruits like amrood kha liya, apple kha liya which are extremely good.

Okay. Okay. Alright. And vegetables also.

Vegetables. Papaya sir, papaya. It's very good.

Okay. And sprouts. Sprouts.

Okay. People say that, used to say, doctors used to say that insulin, ek baar aapko chini ki bimari ho gayi, you can't reverse it. Liver ki bimari ho gayi, reverse hoti hai, nahi hoti hai.

you can improve your situation. Can I tell you about diabetes? Yes.

If a person loses weight and becomes underweight, the chances that diabetes and the medications will go away is about 80%. Which never used to be told to us before. Yes. So even if you are insulated in the sense that Your thyroid will become better, your diabetes, your blood pressure, your cholesterol, all of that will become better once you are less than normal weight, if you were overweight before. or obese before.

Okay. Take it. Even time too. Of course, of course.

And then exercise. Okay. You have to utilize the sugars.

Okay. I think all the cameramen are listening very carefully. They are listening, right?

Because they sit all day. Yes. Okay, that's another thing. I wanted to tell the cameramen and everyone that there was a very famous study which is called the London Bus Study. It was from the 1940s which changed the world.

What they did was, in London, there was a double decker bus. Right. So people saw that drivers versus conductors. Drivers are fast, conductors are going fast. Because conductors were climbing up and down.

down while drivers were sitting all the time. So, I would like to say to all the drivers who are listening to this podcast, all drivers, all those who are having sitting jobs, please make sure that you move. There is blessing in every action.

So, those whose job entails long hours of seating, like those who are working in a bank, tellers, salespersons who can't get up, accountants who have to sit can't get up. Another thing is most people have smartwatches or smartphones. I've been told that keep an alarm.

Like people keep an alarm to drink water. You know, even I didn't think of it, Dr. Fahad. If you need an alarm for your health, I think you outsource it to somebody.

You don't need that and don't count steps, count miles. or kilometers. Okay. Don't do that.

And park your car at least one kilometer away from your workplace. Per force. Per force. Never use elevators. Only use stairs.

Elevators are for patients. For a normal person, stairs. Chai 10 talla chadna ho, chai 20 talla chadna ho. Chadna hai. Main normal ho.

Main patient thodi hai. Patient ke liye lifts bani hoti hai. Na doctors ke liye, na normal aadmi ke liye.

So park your car a kilometer away. from the workplace is a very good advice. It took 10 minutes.

It was an amazing exercise. Even if you don't think of it as exercise, it's happening. It's a habit.

Fabulous. Yes. Okay, fabulous suggestion. What else, doctor?

How else can we improve our lives? More than anything else, make us live happily longer. Yes, yes.

So, I have written in this book also, there are 50 tips, life-saving longevity tips. And one of the tips... which I would like to specially tell people is that you are responsible for your kids.

And health education, specially like polycystic ovary, the girl doesn't even know. and mother is feeding. So it is the responsibility of the society, of the parents, that the child gets education as health education first, school education as number two.

If you teach the child in first three years, that this is not food, we are not told, this is our food. The child cried, you gave him a popcorn, you gave him a burger, you gave him a sweet. Sweets dedi.

It's totally wrong. Wrong food is not a reward. Not a reward.

If a baby in less than one year, a newborn less than one year, you start feeding fruit juices, by five years the child will get fatty liver. By five years. So it is so important for me to say that the mothers are the best doctors. Never take your child unless for vaccination to the hospital. A visit to hospital in a family should be a rarity.

Going to doctor should be a rarity. Own your body, own your health is a message. And mother, the lady of the house should be educated.

What to eat, what to choose, where to spend. Spend on health. spend on dresses it's not what you wear it is on what you wear on what you wear if you have a beautiful body which is your neighbor's envy and owner's pride okay my goodness if you have a body yeah then so why can't you be proud Before that, see how I am. What am I? So that is what the mother and the family should decide and spend time.

And this is the message. Do not need to go to doctors. We need a healthy India. We need everyone to live long. We do not want to use medicines.

We want you should be aware of what to do. Dr. Sir, you spoke about the pancreas. You spoke about the gallbladder.

you spoke about thyroid issues. What is biliary? Biliary is called bladder.

So there are two types of circulations in our body. One is blood circulation. It runs through the heart.

Second circulation is between the liver and the intestine. How did you eat? How did it reach you?

And how did you digest the food? That is why it is bile. So we say our bile. In Ayurveda, it is bile. Yes.

So biliary is all the bile which carries fat to digest, to make your intestine motility, all that. To keep your intestine bacteria healthy. To neutralize the mess you have done.

So bile is your second circulation which is extremely important. If that circulation stops, it becomes jaundice. Okay.

If the bile gets damaged, stones get formed in the gallbladder. If the bile is too inflammatory, cancers occur. So how does one know that my... A common person should have...

knowledge that weight is number one and then you can get your test for the fatty liver which is either by ultrasound or more simple if i told you 10 things bloods then you have fatty liver or certain Then how do I know my liver is healthy? If there is fat, it will be found in ultrasound. There is a new test, FibroScan, which is used for finding quality of cheese.

In France, they used to put so many big cheese in it, they used to put how much fat is there, how stiff it is. That is now used in the liver. That is today the first test that we do, how healthy, how... you know soft the liver is that is a fibroscan stiffness of the liver that is another if it is stiff that means bad bad if it is fatty it is bad so uh the idea is that if it is stiff that means fat cover has been hard because of fat it has calcification kind it is scarred scarred Okay, the fatty liver say scarred liver banana I got up a liver fibrosis card to heart we vessel sector kidney be Vessi you sector lung be Vessa Oh, sir. So this is a simple way.

I hope I have not confused you totally What is so today the fat can be estimated in the liver by three four things one is your sugar level if sugar is high Two, if you have ultrasound which shows fat in the liver or a fibro scan shows or a simple another test is a blood test called SGPT. If SGPT is normal for a female and male, if it is less than 20, it's very good. So if you want to live long, keep your SGPT around less than 20. And I think it's mostly doctors say your triglyceride is high, which means SGPT, right? No, no, no, no, no.

That's different. That is different. Okay.

Triglyceride is fat. SGPT is a marker of liver injury. Oh.

The healthier the liver, the lower the SGPT. In children, it is normal value in India is 40. But ideally, 20 is good. Everyone knows about Hemoglobin. But everyone should know about SGPT. This is an important test.

It is a very... It is a test worth Rs. 20 and it is very good for you to know. So, all of this should be done in the A&I.

Yes. Courtesy of the priest. Yes, done. Okay, we get that done.

We get that done. Right, that is true. My question was on hepatitis since it is within your scope. What are the, because there are lots of mindsets associated with hepatitis. So, I want to come to that.

What are the different types, the inoculations which are available? How should we look out for that? So, there are five types of hepatitis. See the hand.

This is Choti Ungli, little finger. So little finger means Hepatitis A. Hepatitis A occurs in children. So nobody will ever forget five types of viruses. The little one is your fatty liver, sorry is for children, Hepatitis A. Then comes Hepatitis B, Hepatitis C, Hepatitis C.

hepatitis D and hepatitis E. So let's say hepatitis E is in adults. Hepatitis A in children both are by food and by water.

Now like if it rains, so hepatitis E is the common. It is the kind of epidemic form of, you know, that 500 people got jaundiced at once. In Kanpur, 20,000 people got jaundiced. In Delhi, in 1956, 50,000 people got jaundiced. That was all hepatitis E.

It occurs in adults, children may be also, but generally adults. And hepatitis A is in children. Then B, C and D. So these three are blood-borne. But the A...

Admi se dusre mein jayenge blood ya blood products. Okay. Body secretions. Then only it can transmit.

So, jayese mother is positive, so hepatitis B will come from mother to the baby. Ab saare blood banks humare itne achche ho gaye ki. They test. They test kar lete. To ek admi se dusre admi hai, blood ke through bahut kam jayega.

All hepatitis B today generally is mother baby. Hepatitis C is mother baby. Not mother baby. It's.

Sorry, blood transfusion. Rarely blood. And hepatitis D is through hepatitis B.

Both of them work together. To simplify, our problem in blood is B and C. Okay. And inoculations are available for?

Hepatitis A. A. Which is found in children. Yes. It is found in children.

But generally, in India, 60% of children have it. It happens to older brothers and younger sisters too. Okay.

Because it is familial. And once it happens, children are left alive for life. So, is it better to? inoculate or is it better that ho jaye?

If you are very high society, elite, yahaan pe sab apna apna paani khud leke jaate hain, kabhi koi exposure nahi hua, proper hygiene hui, toh lagwa hi lena chahiye. Jo common bache ghoomte hain, kuch... Whatever you eat, they get Hepatitis A. Resistance.

It's small and they stay alive for life. So that's A. But I won't recommend that everyone should take it.

And for E? Hepatitis B. E doesn't have any vaccine. Okay, it's only preventive.

It's not D, it's not C. So, there are two vaccines, A and B. Okay. So, every newborn should get B. Born, after that 6 weeks, 10 weeks and 14 weeks.

14 weeks, 4 injections. So, everybody should get inoculated. Did you get it done? Yeah, I think it was part of our, when the children had it. Because when we were children, we didn't have it.

So, what happened now? When maternal health came, we had to do that. So, you got the vaccine done? Yes, I got the vaccine done. You got it?

So, are you vaccinated or immunized? Immunized means you got antibodies. Antibodies, yeah.

If I get, okay. So if you are vexed. You must have had it because when you had a baby, the gynecologist will tell you.

Before you have a baby, if you are planning to have a baby, the doctor will tell you to get an immunology test done to see whether you have antibodies for that. So if you are immunized, you will have antibodies to hepatitis B. That is more than 10 units means you are protected. So getting vaccination is not equivalent to immunization.

So we must be immunized for hepatitis B. But everybody doesn't need to get it tested. Doctors need to get tested. yeah healthcare workers ki aave meri antibody hai next patient aaya toh main usko handle kar sakta hu I will not be able to get the infection from the patient and women who want to get pregnant yes should be immunized so even if you've had an immunization vaccination as a child you can't be certain that you have the antibodies in you so women who want to get pregnant should first see whether they have antibodies otherwise they will give that to their children. Am I right?

Yes. Sir they recommend a torch test also no? Yeah that is for other infections. Okay.

Yeah so now coming to hepatitis B how do you eliminate hepatitis B from India two simple methods okay one is every newborn is vaccinated so it will end transmission will not happen and although who are infected should be treated. So, current policies are not so clear but we are pushing that treat all infected and protect all who are likely to be born or are being born. And that's what the goal should be.

Hepatitis B slowly can be eliminated. If you start today, it will take 60 or 70 years. You can plan with 21 to in 2100 it will end somewhere right we in one of your talks I saw which I want our viewers also those who have not seen that talk Nash what is Nash I want you to explain that to me now. I saw the talk, but those who don't have access to it and haven't seen it. So who is Aish?

Aishwarya Rai. So you have seen the whole of it? I've seen that, yes.

Okay. ash and the ash word ashwarya is alcoholic steatohepatitis. I mean it's not to put ash into that but ash is alcohol, steato means fat and And fat induces hepatitis.

So, the alcohol you were asking about, there is fat in the liver. That fatty cell is not a good cell. So, the body's immunity kills the cell.

And that is hepatitis. It becomes a battle of the Kurukshetra. Everybody is fighting.

Everybody is fighting. And the liver cells die due to alcohol. That is ash.

But if the same thing happens without alcohol, it is NASH. So, non-alcoholic steatohepatitis. So, what happens? What injures the liver?

There are three things. Virus, alcohol and fat. So people know two. That it will be bad because of virus, alcohol.

They don't know the fat. In fact, 1% of the population is aware that fat is bad for liver. If you take a survey.

It's okay, man. It's okay. Eat it.

Fatty liver, what will happen? About alcohol, 80% of the people know alcohol means bad liver. But not about fat.

And through you and asking this question, Nash, is so important. Remember, fat can cause same injury and even more. Okay, now a person is taking drinks already and he is also fat, what will happen to him?

It multiplies. This is a multiplier effect. Like you are taking drinks every evening, you are taking fatty food and over...

and diabetes too, so they left. That is why a diabetic should be very careful and overweight should be very careful that I should avoid drinks. First they should come in shape, then we'll see. And it's not just self, it impacts on the entire family. Because you fall ill, there are medical bills, your children have to take loans to pay those medical bills because they're not going to let you die.

So they're going to take loans. That loan means that they cannot then educate their children. So if you have this ailment, don't think that it's a joke and it's just you. You're impacting on the future of your grandchildren too. I'm sorry I'm sounding very moralistic.

But I think... This is true. This we see every day.

Sir, whatever you do, we sold our farm, sold our house, even kept our jewellery, sir, save it. But you can't. A 24-year-old man who has drunk, who has just got married, needs a liver transplant.

what you were asking. And liver transplant because of alcohol. What did his wife do?

She didn't make any mistake. The man drank so much alcohol that now he has to get transplanted. In their 20s? 24, 26. They need a liver transplant.

They need a liver transplant. Now what mistake has that woman done to get married to such a man? And now she has to give liver because she will do anything for her husband.

An Indian lady will do anything for her husband. And now suppose they have a child, two year old. The doctor is in dilemma.

What to do with her? She is doing this to save him. Suppose by any chance the husband doesn't survive. Donors survive.

Normally 99.5% survive. But the patient is so ill. He has jaundice, 30 bilirubin, he is advanced, he is bleeding. May not survive.

then what do you do? Now the wife has given the liver has a small child in the lap and the husband is no more and they have spent all the money. And this is not uncommon. And people do not understand that alcohol say, how many problems are there? Today, in ILBS, almost 50% admissions are due to alcohol and liver disease.

And we cry every day. Where is the society's judgment? Nobody is there to tell them.

And most people we have asked about alcohol, they say, sir, no one told us. If you have jaundice, still drink. If there is an accident in the car, your tyre is flat, you immediately stop the car.

You stop it with a little sound. Even after jaundice, you keep drinking. You don't understand.

And poor wife, Nowadays, ladies have also been drinking a lot. We see so many 32-year-old ladies who need transplant. So, I think the society at any time must understand where they are going.

And alcohol is a poison. It really harms. And as you rightly said, two generations of expenses don't come out. It becomes such a bad situation. They become, you know, almost like...

Treatment is so long. Treatment is so long. Yeah. It's lifelong. you have to have medicines after that, which just to survive, forget about quality of life.

Yes, just to survive. Just to survive. And it impacts on generations. Yes.

Right. What is it that you see, which gives you hope that people are getting more aware of their health issues? Do you see any significant change in the sense that our schools and colleges doing it?

Is our governments making... Healthy living a priority. Is there anything that you are seeing a ray of hope? I am not too sure but India is the first country where fatty liver screening has become a part of a national program.

People were only talking about five organs till now. They would talk of brain. talk of kidney cancers or heart but India in 2021 included liver in the national program screening program other countries will take five years so India has done well but as a society when I see how many people meet while running in the park hardly how many people keep their weight in mind hardly where are these priority games in school should be there is a period of PT they call my child get him out of PT you know the senior influential people would not like that their child should be in the PT with general people but while physical exercise is so much important important.

Okay. So I do not see any change in the attitude of the people. Government can make policies. Government can take initiatives. But people like you, people like who are the media people can make a difference.

You can say well we want health indices. We don't want disease indices. Today in India 30% of people are healthy.

In 2030, we will have 35% healthy should be there. Get my point? We need 5% more population to be healthy. Perfect health.

Who is healthy then? Yeah, that's a very good question. Who is healthy who meets all the criteria's blood, weight, physical activity by any international standards. This survey was done. There is a famous study called HELENA.

H-E-L-E-N-A Like the Greek goddess. So HELENA study was done in 10 European countries for children between 12 to 17.9 years. Just for 6 years. They found that 60% of the youngsters don't eat healthy food.

They found they can't do exercises. And the whole European Union started moving. This was 2005. They did a follow-up in 10 years.

The society has changed. We need similar studies of intervention. Today where we are? and after five years where we would we started a study called smiles stronger india through million health educated students smiles is a study which we will take one million student across india we have done from delhi almost 18 000 now so this survey is the one which will tell you and your family that you are healthy or unhealthy are you in the red lane are you in the yellow lane or or you are in the green lane. Those who are in the green lane, students to keep in the green lane.

I am healthy. No problem with parents. I am not in my own. And I am fit. I can run.

If you are in the red lane, parents had diabetes, blood pressure. I am also fat. I am in the red lane. How do I come from red to yellow? So this program and similar such initiatives are required.

Bottom of approach. Whole of society approach. So I do.

Do urge, you keep doing these similar activities and we will keep pumping in small, small snippets. Okay, that sounds great. Sir, I just wanted to know this Ozambic drug, which is anti-obesity drug, this is very much in.

Now people want to opt shortcut. They don't want to go for the exercise and all. How dangerous it could be? I'm not saying dangerous, it has its benefits. It's a very reputed drug and these are, you know, like physiological things.

GLP-1 agonists are very physiological things. They are in things, biggest markets, you know, two major companies, I don't want to name them, have made tons of money in this. But how long can you take?

Suppose you are 18 and you are overweight or obese, is that going to help? No. I think these are drugs are really meant for preventing something like cardiac events or you know some fatty liver event for a short time. Morbid obesity also right? But I don't think they are.

solution secondly they cause many other like you have loss of fat but your muscles also become somewhat weak so we call it sarcopenic obesity so slowly your muscles become weak thirdly you may may have, you know, some stone formation in gallbladder, pancreas, some other GI side effects. So if somebody is already overweight or having a disease like heart disease, diabetes, they are good for diabetes. But I wouldn't say that one third of Indian population is on these drugs.

I don't think it's a solution. It's for selective few, carefully chosen that doctors should use their discretion. This guy.

I cannot do it. There are many other ways of losing weight. For example, putting a balloon in the stomach.

We call it intragastric balloon. You have stomach of this size. There is a balloon which comes, you fill it with water. So, the size of the stomach will be reduced.

So, within 6 months, you lose easily 20 kg or so. Slight discomfort, but you can lose weight. You have bariatric surgery.

But the surgery has a problem that it is one time and then. You can't reverse it easily. And that is not. a solution after that people start eating more. Now you are bariatric, eat it.

There is no use of that. So it's actually mind transplant. That is important. It is not the liver transplant or bariatric or anti-obesity drugs.

I would say we have to accept we are the culprit. If you lose yourself, then who can win? So transplant good ideas into your mind.

Yes, transplant good ideas into your mind. You can only be defeated by yourself. Then you don't need liver transplant Good brain transplant Or mind transplant Mind transplant I'm not saying brain Mind transplant I will read a couplet for you. Don't think about how many moments are in your life. Think about how many moments are in your life.

Live the moment. How many moments are in your life? So make your life so happy. But for happiness, you can't buy drugs. You can't have drugs and have happiness.

No way. So don't outsource your health. That's what the message is. own your body it's not written for the pleasure of writing it's written with an extreme you know kind of necessity when I see a guy who brought his father for transplant look at his neck it's not a neck how can you liver dega apne father ko?

Tera khudka haal hi hai. That burden you asked na. The people who come you realize how unhealthy their children are and that makes you so sad.

What kind of a doctor? What you have done? You are a useless guy. Unless you change the thinking. So very important for us is not that anti-obesity drug.

It's a mind transplant. Change in your mind. And and mindset.

Right. On that note, thank you so much, Dr. Saab, you gave time and wish you a happy Doctor's Day and all our best wishes to you in spreading information about what it means to be healthy for an individual, a family, a society and a country. Thank you so much, Dr. Saab. Thank you, Dr. Saab. for having me with you and thank you, Shalini.

It's a great pleasure. Thank you. Thank you.

Thank you for watching or listening. Thank you for listening to this edition of the ANR podcast with Smita Prakash. Do like or subscribe on whichever channel you have seen this or heard this. Namaste. Jai Hind.