The Silent Belly Fat Trigger MOST Doctors Miss! | Dr. Pradip Jamandas

1. 0:00 – 2:48

   What fasting does metabolically: switching from glucose to fat-burning

   1. RCDr. Rangan Chatterjee0:00

      What happens in the body biochemically, physiologically when we start fasting? Because I think for many people, they're gonna need that knowledge and that science to convince them that, actually, you know what, maybe I should give this a go.

   2. PJDr. Pradip Jamnadas0:16

      Yeah, yeah, yeah. No, absolutely. Absolutely. You know, what fasting does, it allows the body to do what it was made to do. You see, we eat, eat, eat. Insulin comes in, puts everything into storage, so you build up some fat. And then you're supposed to live. So when you live, you now start utilizing your calories a- and you start burning the sugar. When that goes out after maybe about four hours or five hours, then the, you know, glycogen stores in your liver and in your muscles start breaking down, start giving you the calories that you really need to burn so you can run, do your day-to-day activities and all that. And when you run out of that by, let's say, about 18 hours or 20 hours, and then the body says, "Hmm, I need to start burning fat now." That's what you're supposed to do. That's why you put on fat in the first place. That's why we have fat. It's a storage. And then you start burning that fat, and therefore you start burning that fat so the fat comes out, comes into your liver, gets converted to some ketones perhaps, and now you're making ketones, and the ketones are being utilized for energy. And then, uh, you go for your next meal again. So the body was made to do this. It was not made to just pile on, pile on, pile on all the time, because that, th- that results in increased fat stores which you'll never break down. So your body was supposed to do this. From the, from the, from the design, you're supposed to do this. So the important thing is that when you eat and you're taking calories, your insulin level obviously goes up. Why? Because insulin has to get that sugar out of the bloodstream. S- Blood sugar must always come down, because otherwise you get damage from that high glucose level in your bloodstream. That's why we treat diabetes, right? Because the blood sugar, or the glucose rather, attaches itself to proteins, get glycation end products, and therefore these proteins become, m- they, they become dysfunctional. So insulin says, "I'm gonna take the glucose out, put it down into the bloo- uh, into the storage." First place it puts it into is the liver. When the liver stores are full, then it spills over into the pancreas. More calories coming, there's more glucose, then it goes into the muscles. And it stores everything, and from there into the skin. And that's the way it was supposed to be. But now when we continue to do that, we just keep piling it on, piling it on, and we never get a chance to burn it down, and we're supposed to burn it down. So the biochemistry of the body was made for feeding, fasting cycles, and this is the way the, the, uh, the, the bio- bioengineering of our body was, but we became dysfunctional because

2. 2:48 – 3:49

   Insulin’s central role: why frequent eating keeps the body in storage mode

   1. PJDr. Pradip Jamnadas2:48

      as food became more available, we just kept piling it on and on and on and on. And that's the problem that we have today. It is exactly what you said, excessive calories too frequently. So our insulin levels stay high all the time. So that's the biggest problem I've found as a cardiologist. You're eating all the time, you're stimulating your insulin all the time. Insulin stays high, stays high, never gets a chance to come down. And because your insulin doesn't come back down again, you're always in a storage mode.

   2. RCDr. Rangan Chatterjee3:18

      Yeah.

   3. PJDr. Pradip Jamnadas3:19

      This high insulin is the problem. We've hormonally changed because we're eating too frequently. We're not designed to ea- eat that frequently. Insulin's supposed to go up, then come back down again. Up and back down. We stay up all the time, so your body develops, in a simple terms, insulin resistance. Now, the next time you eat, you need even more insulin because just like wearing a jacket, you first feel it, then you don't feel it. The body, when it has high levels of insulin

3. 3:49 – 4:19

   A cardiologist’s clue: heart disease with ‘normal’ cholesterol and blood pressure

   1. PJDr. Pradip Jamnadas3:49

      all the time, it becomes insensitive to it, and that's what's happening. We are a hormonally modified human being now. We're becoming insulin resistant, and this insulin resistance results in higher and higher insulin levels, and that's the problem I found. And I just wanna digress a little bit, and I'll tell you how I came to this. In my practice, what was happening is patients were coming in with heart attacks and hardening of the arteries and angina, and I said, "Okay, there must be a cause." And I looked for it, and the cholesterol m- most

4. 4:19 – 4:49

   Finding hidden dysglycemia: impaired glucose tolerance and early intervention

   1. PJDr. Pradip Jamnadas4:19

      of the time was okay. Blood pressure was okay. They were not diabetic. And then I see all this hardening of the arteries, and I'm wondering why. So about 12, 15 years ago, I, I started doing sugar tests on them, and I found that they actually had mild diabetes, what we call glucose intolerance or impaired gluco- fasting glucose. So the sugars were just slightly high, but not enough to make them a diabetic. So I said, "Okay, fine. So I should put these patients on something to sensitize them and make them better." And I put them on metformin, and I got a lot of resistance from a lot of physicians

5. 4:49 – 5:40

   The Kraft test insight: massive insulin response despite ‘okay’ glucose

   1. PJDr. Pradip Jamnadas4:49

      in the community, plus patients, uh, but the outcomes were better. They, they actually did better. Then I started doing insulin testing in my office, and I started doing this when I read, uh, some information from, um, uh, fr- from a, a physician, uh, who wrote a book on, on, on insulin, and he c- Dr. Kraft.

   2. RCDr. Rangan Chatterjee5:09

      Yeah.

   3. PJDr. Pradip Jamnadas5:09

      So it's called the Kraft test. So now what we do is we give them sugar water, patients, and we measure the i- the sugar levels going up and back down again, and said, "Okay, it went up a little bit. Not too bad." But I looked at the insulin response, and it was massive in these patients. So I took 100 patients, and I saw that they were making so much insulin, and I said, "This is ridiculous. Why are you making so much insulin?" Well, they had insulin resistance. And then I linked the fact that it's the high insulin level

6. 5:40 – 6:24

   ‘By the time A1C is high, it’s too late’: long lead-time of vascular damage

   1. PJDr. Pradip Jamnadas5:40

      that's actually causing the hardening of the arteries because the sugar levels are okay. Of course, what happens is over time, it's taking a gallon of insulin to bring your sugar levels under control. Eventually, even that's not enough.

   2. RCDr. Rangan Chatterjee5:53

      Yeah, yeah.

   3. PJDr. Pradip Jamnadas5:53

      So then the sugar level goes up, and then they go to the doctor and say, "Oh, yeah, sugar levels are high," or, "Your hemoglobin A1C level is high."Now you're a diabetic. Well, guess what? It's too late. You already have all the hardening of the arteries. You've done so much damage to your arteries, you probably did it for 15 to 20 years. And that's the discovery, and that's what really motivated me to make these changes in my patients, to say that, "Look, you know, I gotta get that insulin level down." And it is that high insulin level that really motivated me-

   4. RCDr. Rangan Chatterjee6:24

      Yeah, yeah

7. 6:24 – 7:26

   Why fasting became the practical tool: dropping insulin without another drug

   1. PJDr. Pradip Jamnadas6:24

      ... to really do the fasting program, 'cause I said, "Okay, how am I gonna get insulin levels down?"

   2. RCDr. Rangan Chatterjee6:28

      Yeah, yeah.

   3. PJDr. Pradip Jamnadas6:29

      "How, how do I do that? I don't have a drug." So that's what... Look, the whole thing comes down to insulin, for me it was. Now, as things happened, I discovered more and more fun things that, in this fantastic journey. But the bottom line is, it was the high insulin level that really got me into this, because I found that when I brought the insulin levels down, my coronary artery disease, atherosclerosis, just went down. Patients did so much better. And that high insulin level, the only thing I know that really helps to bring that insulin level down, besides metformin and a few other drugs, really, is fasting.

   4. RCDr. Rangan Chatterjee7:05

      Yeah.

   5. PJDr. Pradip Jamnadas7:06

      Because when you don't eat, guess what? You don't make insulin. That's it.

   6. RCDr. Rangan Chatterjee7:10

      Yeah, yeah.

   7. PJDr. Pradip Jamnadas7:10

      Your insulin levels plummet. And then the next time you eat, you make insulin, but a much less amount-

   8. RCDr. Rangan Chatterjee7:17

      Yeah

   9. PJDr. Pradip Jamnadas7:17

      ... because you're now sensitive. So this fasting, I got into it through this way, not because I've, I, I just wanted to make them reduce weight-

   10. RCDr. Rangan Chatterjee7:26

       Yeah, yeah

8. 7:26 – 9:21

   Hypertension rethought: insulin, nitric oxide, and vessel constriction

   1. PJDr. Pradip Jamnadas7:26

      ... not because I just wanna reduce blood pressure. It was really the insulin that got me into fasting. Then, of course, I discovered, as time went on, that, my God, the blood pressures were coming down, and I realized that insulin is a vasoconstrictor. It reduces nitric oxide in your blood vessels, so therefore your blood vessels can't dilate. Now, that brings me to hypertension, that I said, "Oh, my God." I was taught, and you were taught, that 95% of hypertension is essential. And this very word essential, [laughs] there's nothing essential about hypertension. You don't need it. So I discussed-

   2. RCDr. Rangan Chatterjee8:04

      Sh- shall we just, should we explain to non-medical listeners what, what does that term essential mean? When we say essential hypertension, what do we mean by that?

   3. PJDr. Pradip Jamnadas8:12

      It means we don't know the cause of it. It's idiopathic. Idiopathic is another word we use, uh, which means we don't really know clearly what the cause is. It's just something that just happens. So this essential hypertension is not really essential. You don't really need it. [laughs] And I found, through my own experiences here, that the fasting brought the blood pressures down. And I said, "Okay, so what's the correlation? It's insulin." I started reading more about insulin, and sure enough, when you give patients an insulin shot, the blood pressure goes up.

   4. RCDr. Rangan Chatterjee8:43

      Yeah, yeah.

   5. PJDr. Pradip Jamnadas8:44

      You take them off insulin, blood pressures come down. Insulin causes nitric oxide depletion in the blood vessels. Nitric oxide, by the way, is a vasodilator. Yeah. Nitric oxide is a natural endogenous product that makes your blood vessels dilate. And then when nitric oxide goes down, the vessels constrict. This is a dynamic state that you're supposed to have. You walk into a cold room, your vessels constr- uh, constrict. That means your blood vessels go down. When you go into a hot room, your vessels dilate. That's a normal response. This nitric oxide is most essential in our body. It is so important for blood vessels that, in fact, there was a Nobel Prize awarded for this nitric oxide, as you know.

   6. RCDr. Rangan Chatterjee9:21

      Yeah.

9. 9:21 – 10:04

   Clinical results: medication reduction and a more effective BP strategy

   1. PJDr. Pradip Jamnadas9:21

      So for the audience to realize that insulin, when it comes down, your nitric oxide production goes up, and therefore your vessels dilate appropriately. Your blood vessels are not imprisoned anymore, and blood pressure started coming down. I said, I said, "This, this is amazing."

   2. RCDr. Rangan Chatterjee9:39

      Yeah, yeah.

   3. PJDr. Pradip Jamnadas9:39

      Because for the first time in my life, I felt that the patients were doing something that was actually bringing their blood pressures down. I mean, we always tell patients who have high blood pressure, "Okay, avoid excess of salt, and go do some exercises," and those are fine, because they also can improve nitric oxide production. But this was a very powerful one. When I brought that insulin levels down on these patients through fasting, blood pressures just plummeted, and I had to actually take patients off blood pressure medications.

   4. RCDr. Rangan Chatterjee10:04

      Yeah, yeah.

10. 10:04 – 10:51

    Why weight drops with fasting: ‘unlocking’ fat storage by lowering insulin

    1. PJDr. Pradip Jamnadas10:04

       So that was a huge thing that I found with insulin. So fasting seemed to me the, the best way to, to, to really make the patients' blood pressures come down, and I found that their weights came down. Now, the question is, why did the weight come down? Well, insulin, you know, bottom line for all your listeners, insulin just is a storage molecule.

    2. RCDr. Rangan Chatterjee10:28

       Yeah, yeah.

    3. PJDr. Pradip Jamnadas10:28

       Puts everything in storage. So when the insulin levels come down, the storage padlocks are taken off, so your fat can now be mobilized.

    4. RCDr. Rangan Chatterjee10:37

       Yeah.

    5. PJDr. Pradip Jamnadas10:38

       Now, there's, of course, I can go into all the enzymes that are involved and, and the, and the hormone-dependent lipase, et cetera, et cetera, et cetera. But the bottom line is when insulin levels come down, now your fat pads are available-

    6. RCDr. Rangan Chatterjee10:51

       Yeah, yeah

11. 10:51 – 12:37

    Aesthetic and adherence differences: fasting vs frequent small meals

    1. PJDr. Pradip Jamnadas10:51

       ... for metabolism. And I found that the fats just started coming off the patients. And when I would look at these patients who would do the fasting program, I'd look at them, and I said, "They look great." It's not like their faces are all, you know, the, the excess of skin hanging off or they have skin hanging off their arms. No. Fasting patients seemed to lose weight in a more beautiful way, that they were actually losing fat, but they were also losing the s- right amount of skin as well.

    2. RCDr. Rangan Chatterjee11:23

       Yeah.

    3. PJDr. Pradip Jamnadas11:23

       Because, you see, prior to this, prior to this, I used to tell patients, "Okay, you're gonna cut your calories to only 850 calories a day, and you're gonna have, uh, four meals a day. Each one is gonna be this much." And the patients would come back, sure, they lost some weight. They would los- lose a lot actually sometimes, but they would look terrible. They would look absolutely terrible, their faces, their skin, and, and, and plus they were miserable because th- they just never en- they didn't feel good-

    4. RCDr. Rangan Chatterjee11:53

       Yeah, yeah

    5. PJDr. Pradip Jamnadas11:53

       ... eating small amounts of food frequently. This advice that we gave patients previously, that, "Hey, cut your calories down by eating four small meals a day or nibble throughout the daytotally wrong in clinical experience. They lost temporary weight. They all would put it back on again. Did it for years. I did it for 15 years, and I was sick and tired of it. They would come back miserable, saying, "Doc, my, my life's miserable, and I only eat this much, and I just feel terrible. I'm hungry all the time." And I look at them, they sure even look miserable, and their skin was just... So when patients were fasting, they would come back and they were laughing. They were, they were so happy.

    6. RCDr. Rangan Chatterjee12:36

       Yeah, yeah.

12. 12:37 – 16:32

    Brain, energy, inflammation, and gut improvements reported during fasting

    1. PJDr. Pradip Jamnadas12:37

       The mood was better. And I said, "Well, why is this guy's mood so good? He hasn't eaten for two days now." And he says, "Doc, my mood is better than it ever was before. I'm sleeping better as well."

    2. RCDr. Rangan Chatterjee12:48

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    3. PJDr. Pradip Jamnadas13:09

       Uh, and he empowered himself. And I said, "No, w- this is psychological. He's just, you know, he was able to do it, so he's feeling good about himself." He says, "No, Doc, I, I do feel good that I was able to do it, and, and I, I'm self-empowered." But also, they felt better. And then, of course, as I do the research, I see that there are many substances that are produced during fasting, and one of them is BDNF, which is a big word for brain-derived neurotrophic factor. And what that really basically means is, look, when you are fasting, does nature want you to just crawl into your, into your cave and fall asleep a- a- and just, just, just, just die? No. Nature wants you to go out there, find your kill or your, or your prey or your, or your, find your berries or something. So it actually makes your brain more alert, in- rejuvenates your brain. And, and you actually, now there's data to show that you can actually grow new cells as well in prolonged fasting. So what happens is that you actually become more wide-eyed and bushy-tailed.

    4. RCDr. Rangan Chatterjee14:16

       Yeah, yeah.

    5. PJDr. Pradip Jamnadas14:16

       And that's what I saw with the patients, too, that they were, they, they were so happy when they walked into my office. They're walking to a cardiologist office laughing and joking. I said, "This is fantastic." So and then, so that's something. And then I found that the, the, the energy levels, they just not only felt better mentally and, and, and, and their mood was better, but they said that they moved around better. So I said, "What does that mean?" They said, "Well, look, my aches and pains went away." I said, "Come on." They said, "Yes. I only lost 15 pounds so far, but my joint pains are all gone." Now wait a second. Why is that? Why did the joint pains go away? You don't take off that much weight to take it off your knee. Well, there's inflammation. And I found that inflammation went down in these patients.

    6. RCDr. Rangan Chatterjee15:00

       Yeah, yeah.

    7. PJDr. Pradip Jamnadas15:00

       So I said, "Okay, so how do I measure inflammation?" So I looked at the CRP levels on these patients, and I found that the CRP is a blood test, and the, and your audience would know that is a test that we do to look for inflammation, micro inflammation in your blood vessels. And I found that they were coming down. Now, you know how hard it was for me to bring these inflammatory markers down. I mean, you know, we give patients statins, and, and that does bring down CRP. But I found that these patients who are fasting, the CRPs levels came down, and perhaps a lot of the inflammation in their joints was getting better because the inflammation went down. So I said, "Okay, that's fine. What else are you feeling?" They said, "Well, you know what? My, my stomach feels good, too." I said, "Wait a second. Come on, guys. I mean, you're fasting, and how can this be happening to you?" They said, "Yeah, less bloating. Uh, my bowel movements are better. Um, I'm not getting so gassy, and I don't get that fatigue after eating. You know, I just, ugh, I just feel so down." Of course, they're not eating. But when they do eat, after the meal, they feel so much better. So they are eating after, when they break the fast, but they're feeling better. Their guts are better. Their joints are better. Their minds are better. I just said, "Oh, God. Th- this is crazy. This is crazy." So that's what really- [laughs]

    8. RCDr. Rangan Chatterjee16:21

       Yeah, yeah

    9. PJDr. Pradip Jamnadas16:21

       ... I got so excited about fasting, as you can tell. I, I just, it is amazing journey.

    10. RCDr. Rangan Chatterjee16:25

        [upbeat music] If you enjoyed that short clip, I think you are really going to enjoy the full conversation, which you can check out here.

Episode duration: 16:46