Explore every episode of the podcast Meta Health: Mindfulness Meets Metabolism

Peter was kind enough to allow me to re-release our interview from 2019 from his podcast, The Drive, Episode #69. Many people have found me through Peter and told me this was one of their favorite episodes. Aside from insulin resistance and metabolism, we end the discussion with a topic that really resonated with Peter, which is the impact of generational stress, social media, and devices on youth and how I've navigated this in my own personal life. 

This is longer than my usual episodes since we cover a ton of important topics, so I included detailed timestamps below. I hope you enjoy this important conversation. 

• Peter's overview and perspective on our discussion (0:58)
• Surprise moment for Peter from our discussion (2:30)
• How a tough case of insulin resistance led Peter to my work (5:08)
• Metabolic disease in South Asian and East Asian patients (5:54)
• Triglyceride paradox in African Americans (10:38)
• Visceral vs subcutaneous fat and shortcomings of BMI (11:30)
• Cortisol and glucose variability (25:00)
• Mechanistic discussion of insulin resistance (27:20)
• Origins and evolutionary theories on insulin resistance (37:00)
• Brown adipose tissue and impact of climate patterns on insulin resistance (46:43)
• Vitamin D and hyperinsulinemia (50:38)
• Uric acid, high blood pressure, and fructose metabolism(54:05)
• VO2 max and Zone 2, including ethnic diferences (56:23)
• Zone 2 fitness testing to evaluate mitochondrial performance (1:01:15)
• Exercise for long-term functional health (1:01:00)
• Lifestyle changes to improve insulin resistance and other metabolic phenotypes (1:02:55)
• Aging and leg strength (1:09:59)
• Ron's approach to exercise and stress management for those with little time (1:10:00)
• Ron and Peter discuss stress management (1:13:00)
• Ron discusses his 5S approach to fatigue and stress management (1:16:00)
• The impact of family dynamics on health risk (1:17:00)
• PCOS (Polycystic Ovarian Syndrome) and its link to insulin resistance (1:18:34)
• Stress, adiposity, and weight loss resistance in females(1:20:00)
• Sleep apnea and insulin resistance (1:29:00)
• How a culture of achievement and expectations can lead to undue stress, unhappiness, and health problems in our children (a Silicon Valley case study) (1:30:10)
• The negative impact of devices and social media on children and Ron's approach to managing this (1:40:00)

Is alcohol really a low carb, keto friendly substance like many ads and influencers claim, or is there more to it? Even if the glucose on your CGM (continuous glucose monitor) doesn't budge after a drink, there are real metabolic effects on glucose and body fat you should be aware of. Non-drinkers will benefit from this episode too since we cover some key metabolic principles, along with the following: 

• Quick overview of the metabolic merry-go-round and liver metabolism
• Why your CGM glucose results may be normal or even low after drinking alcohol
• Pathways by which alcohol affects glucose and body fat
• The surprising impact of alcohol on muscle 
• How alcohol is disguised and advertised to be "metabolically neutral"
• My personal approach to alcohol consumption 

In this episode I answer a question from a listener who is confused regarding whether breakfast is optimal or not optimal for health. Although intermittent fasting made breakfast skipping a common practice, there is nuance to this question. We cover some of the following:

• Benefits of breakfast skipping and why it's so common
• Downsides of breakfast skipping and how it can backfire
• Why I personally have added breakfast back in on most days
• Balancing breakfast needs with physical and cognitive demands
• Optimal breakfast composition
• Approach to intermittent breakfast skipping 

Our body has become an obsession that many of us are consumed by day and night. Hollywood and the fashion industry started the movement of creating unrealistic body standards, but now the growing number of celebrity and health influencers have taken this movement and put it on steroids. In this episode I discuss the following:

• Reframing the human body so we don't take it so seriously
• Unrealistic body standards perpetuated by health influencers
• My own personal challenges with overcoming a Type A approach to health and fitness
• Putting an end to familial and cultural patterns of body shaming
• The disturbing impact of social media and AI filters
• Why body composition scans can be a problem
• Strategies for detaching from body/fitness/health/longevity obsession, including a visualization exercise

Eating more protein is currently the mantra being shared by many health leaders and big food has caught on. Are we missing any potential risks in the midst of the high protein movement? This episode covers some of the following topics:

• Lessons learned from the low fat, low carb, and fasting movements
• How higher protein diets are being misused by many
• Understanding the important mismatch between protein intake and energy expenditure
• What happens to excess protein in the body?
• Finding the goldilocks zone for mTOR activation
• Protein intake recommendations for different groups

Much of our emotional unrest results from the act of splitting our identity into multiple roles and different personas. In this episode I explore:

• What's the split?
• Why we split?
• Using imagery to visualize the split?
• My personal practices to quiet the mind
• Shifting towards unification

I'm feeling an urge to shift my content in a new direction. I'm not giving up on discussing metabolism since that's a topic that is still very close to my heart, but at the age of 52 and after digging deep into insulin resistance for well over a decade, I'm sensing a different pull. 

In this episode I discuss my internal transformation and how you too might have a different voice inside that is longing for a new direction. 

This episode takes a fresh look at the 3 fundamental molecular root causes of insulin resistance using some familiar storylines from prior episodes combined with some new story hooks to help you understand the science of insulin resistance. We cover the following:

• Quick review of insulin mechanism of action
• Summarizing the 3 root causes or what I call "-emias" of insulin resistance
• The inflammation-insulin resistance link explained using a busy ER analogy
• Using lifestyle changes to manage the 3 root causes

This episode digs deep into protein and more specifically amino acids (protein building blocks) and their role in metabolism, weight control, insulin resistance, and overall health. We cover some of the following:

• Quick overview of mitochondrial metabolism
• Introducing protein and amino acids
• The role of amino acids in energy production
• Fasting and ketosis
• Can excess protein intake lead to fat/weight gain?
• The link between amino acids and insulin resistance

I've selected 2 key metabolic ingredients, Acetyl CoA and Citrate, to explain nutrition metabolism in further detail. I've also selected a different storyline, the mitochondrial amusement park and the Kreb's merry-go-round, to help you visualize some of the most fundamental steps of metabolism. In this episode we cover:

• Acetyl CoA's role as a key metabolic conductor
• The metabolic merry-go-round used to explain Kreb's cycle
• The importance of the Citrate sensor in switching between anabolism and catabolism
• How these concepts are tied to the root cause for weight gain and insulin resistance
• A critique of B-vitamin supplements as "energy producers"

The mental and metabolic impact of human beings predominantly or exclusively working from home has been profound. I've noticed significant increases in insulin resistant conditions including premature heart disease and a deterioration in mental health. All of these risks existed pre-pandemic, reflecting our modern digital lifestyles, but post-pandemic these risks have intensified to an even worse public health crisis. In this episode I cover some of the following:

• Overall impact of WFH (work from home) on metabolic and emotional health
• Evidence-based guidelines for MED (minimum effective dose) of daily walking steps and strength training minutes per week
• MED for minutes of aerobic training with tips on improving adherence
• Digging into the science of ZEF (Zoom Exhaustion Fatigue) based on Stanford University research
• Impact of WFH on stress and sleep

I see lots of patients in my clinic who aim to lose body fat and have become well versed in the different types of body fat, specifically subcutaneous adipose tissue (aka SAT) and visceral adipose tissue (aka VAT). Although VAT and SAT are both fat, they represent different health risks and there are some differences in terms of which strategies are more effective for VAT vs SAT loss. This episode is a good follow-up to Episode 16 (Getting Your Body to Burn Fat), which provides the scientific foundation for fat loss (aka lipolysis) along with providing practical suggestions as well. In this episode, we cover:

• Overview of SAT (subcutaneous fat) vs VAT (visceral fat)
• How to measure SAT vs VAT
• Dietary approaches to tackle SAT vs VAT
• Deep dive on which exercises and routines address SAT vs VAT
• Other lifestyle factors that address SAT and VAT

GLP-1 drugs have been all over the headlines and the global demand for using these drugs for weight loss has been significant. GLP-1 belongs to a family of gut-based hormones called incretins. In this episode I'll teach you about the fascinating incretin system and how you can influence it naturally to promote weight loss. I cover the following:

• Understanding the incretin system and how the gut communicates with the brain
• How the incretins affect the pancreas and other major organs
• Benefits and risks of GLP-1 agonist drugs
• My thoughts on using GLP-1 for what I call "cosmetic" weight loss
• Non-drug lifestyle strategies to increase GLP-1 to lower weight and lower glucose

The pentose phosphate pathway, which I refer to as P3, is one of my favorite metabolic pathways and one that gets far less attention than glycolysis, gluconeogenesis, and Krebs, yet plays such a key role in our body. In this episode we go over the following:

• Brief refresher on glycolysis and coenzymes using James Bond storytelling
• Deeper dive into oxidation, reduction, and free radicals (aka reactive oxygen species or ROS)
• Understanding and remembering the key functions of P3
• How P3 is tied to obesity, insulin resistance, heart disease, and cancer
• How erythritol is tied to P3 and the fallacy of a study linking it to heart disease

In this Metabyte (shorter episode), I review the interaction of the insulin hormone and its receptor on the surface of the muscle cells using a slice of chocolate cake, a lock and key, and a reference to Indiana Jones. 

Call it holistic, functional, metabolic, integrative, longevity, or whatever, but this episode expresses some of my concerns about the direction of what I refer to as the rising "alt health" movement.

Interestingly, I'm part of both alt health and mainstream medicine, so I'll share my take from both sides. I'll discuss:

• The story of "Dr.Bob," a fictional alt health practitioner whose practice is rife with hypocrisy and questionable practices
• The story of "Diane," a fictional patient anecdote based on patient and audience feedback, who is going bankrupt purchasing alt health services. 
• How the supplement industry is morphing into its own version of "Big Pharma"
• Defending mainstream doctors, an unfortunate target of the alt health movement
• Blindspots and potential harms of alt health messaging
• Some thoughts on how alt health and mainstream medicine can collaborate better

In this episode we will tie together cholesterol metabolism using the boat vehicular model from Part 1, and understanding your own cholesterol results in greater depth. My free cholesterol e-book here summarizes key numbers and concepts discussed in this episode. We'll discuss the following: 

• Review of lipid boats and cholesterol metabolism
• Understanding the impact of lifestyle on blood vessel health
• Key characteristics of lipid particles driving heart disease
• Overlooked cholesterol numbers that matter most 
• Hidden heart disease risks you need to prioritize

Lipid (cholesterol) physiology is complicated, but essential for you to understand as part of metabolism, health, and longevity. Let's simplify lipids (and glucose) using cars, boats, and traffic. This sets the foundation for future episodes where I discuss the practical implications of lipids and heart disease risk. We'll discuss the following:

• The vehicular metabolic traffic model
• Quick review of glucose and insulin metabolism
• Introducing lipoprotein boats 
• Understanding glucose cars and lipid boats together
• What we mean by "fat-burner" and "sugar-burner" 

Glucose variability (GV) is an important metric that expands upon the current limited application of fasting blood glucose and hemoglobin A1C. In this episode we'll discuss:

• The limitations of A1C and fasting blood glucose
• What is GV and why it matters?
• How GV is related to inflammation and chronic disease
• Glucose dipping and its connection to weight gain
• Defining an optimal range for GV

The hemoglobin A1C is a useful, yet imperfect glycemic marker which we'll explore further in this episode where we discuss:

• The origins of the glycohemoglobin test (aka A1C)
• The flaws of A1C testing and why you may not be prediabetic
• Insulin resistant markers that should accompany A1C testing
• The impact of ethnicity on A1C testing
• An exciting new metric that may be superior to the A1C test

There are significant ethnicity-specific differences in metabolism and heart disease risk that are not often discussed. In this episode we cover:

• A brief overview of insulin resistance (IR) and the renin angiotensin system (aka RAS)
• How IR and RAS present in major ethnic groups like African Americans, Asians (including South Asians), Hispanics, etc.
• My simplistic model for categorizing IR to better explain ethnic risk
• Ethnic-specific lifestyle changes to improve metabolism and reduce heart disease risk

I'm going to explain the interaction between blood pressure, body fat, and sodium by explaining the all important RAAS (renin-angiotensin-aldosterone system). Understanding this system can help you optimize blood pressure, heart, and overall vascular health. We'll discuss the following:

• Understanding how RAAS works
• How body fat interacts with RAAS
• Why sodium is not the root cause of high blood pressure
• The connection between insulin resistance and RAAS
• Lifestyle measures to effectively reduce blood pressure 

Understanding the mechanism behind how your body stores and burns fat (aka lipolysis) will help you incorporate lifestyle strategies to help you lose excess body fat.  In this episode we discuss:

• The science of burning body fat 
• Different types of body fat based on color and location
• Teaching your body to burn excess fat through thermogenesis
• Multiple lifestyle strategies to enhance fat loss

Muscles are a key organ for longevity, yet the majority of patients I see in my clinic suffer metabolically, physically, and even mentally from a lack of optimal muscle strength.  Most individuals are also consuming insufficient protein to activate muscle growth.  In this episode I discuss:

• The science of muscle growth (aka muscle protein synthesis)
• The role of insulin and mTOR using a Marvel superhero 
• Defining optimal protein intake for muscle growth
• Vegetarian vs animal protein
• Fasting, exercise and other lifestyle factors affecting muscle

Ketogenic diets are commonly associated with meat-based diets, but this misconception isolates individuals from accessing this precious metabolic state. In this episode I discuss the following:

• Ketosis explained using an ox-powered waterwheel
• Fat burning/oxidation explained using box cutters
• Why ketones are an incredible energy source 
• The health benefits of ketosis explained
• How plant-eaters and meat-eaters can access ketosis

Envy is an emotion very few people like to talk about, but that simmers inside so many of us.  I talk about envy openly in this episode and discuss the following:

• Why people avoid discussing envy
• The impact of envy on our emotional health
• My personal experience with envy
• The parenting impact of envy on children
• Toxic competitiveness fueled by envy
• Practical tips on coping with envy

In this episode I use 4 key coenzymes along with storytelling and visualization to help you understand energy metabolism.  We'll weave in James Bond's Casino Royale and introduce a "RAP" to help you become a metabolic whiz.  Topics include:

• Mitochondria refresher 
• Introducing the 4 key coenzymes
• Major metabolic processes that produce energy
• The role of B vitamins in metabolism
• Cutting edge longevity molecules and supplements

In this episode I do my best to provide an objective, science-based mechanism for how plant-based and paleo-type diets can be effective in reversing insulin resistance.  I cover the following:

• Molecular overview of insulin resistance
• Case descriptions of how plant-based and paleo-type diets can reverse insulin resistance
• Critical role of mitochondrial horsepower
• Overlap areas with plant-based and paleo-type diets
• Key concepts behind dietary personalization

It's time to introduce the liver into our metabolic framework and understand how it interacts with fat and muscle. We'll discuss:

• The metabolic triad of glucose, fat and muscle 
• How the liver regulates glucose with extraordinary precision
• Understanding metabolism when fed, fasted, and in ketosis
• Insulin resistance in the liver and how it's linked to elevated glucose, triglycerides and fatty liver

This episode introduces fat metabolism through signature storytelling that involves ships, TSA agents, and a visit to a pub. We'll cover the following:

• Overlaps in fat and glucose metabolism
• The essence of fat mobilization and storage
• Key hormones for fat storage and burning
• Deeper understanding of insulin resistance and fat gain
• Lifestyle changes to enhance fat burning

In prior episodes we discussed how glucose gets into cells from the bloodstream, but now it's time to dig deeper and understand how glucose and nutrients actually get into the mitochondria to produce energy.  Optimal mitochondrial function is essential for energy, weight control, and disease prevention, so understanding its function is key.  

• Brief overview of insulin resistance basics from prior episodes
• The origin and function of mitochondria
• A college admissions anecdote to explain how glucose gets "admitted" into the mitochondria
• Understanding aerobic vs anerobic metabolism 
• Optimal exercise intensity to activate mitochondria, maximal energy production, and curb hunger

Fasting continues to be one of the top health and nutrition trends in the world.  Why wouldn't it be?  Weight loss, disease prevention and reversal, longevity benefits, and the list goes on.  As someone who has practiced fasting and prescribes it in the clinic, there is a dark side to fasting that is not being discussed.  I discuss some of the following topics in this episode:

• If fasting is medicine, what's the safety, efficacy and toxicity profile?
• 6 categories of high risk fasters
• Fasting in women and vulnerable populations
• Redefining a successful fast beyond weight loss
• Social media impact of fasting
• Fasting health inequities: A Case Study

If this episode resonates, please share with others, post comments on my instagram @roneshsinhamd, or reach out by e-mail at my blog, www.culturalhealthsolutions.com

We laid the groundwork for understanding the root cause of insulin resistance in prior episodes, and now we have reached a major climax in this saga where we discuss one of the molecular root causes for this condition.  There will be some James Bond references and an explanation of insulin resistance using a kitchen power outage as an example.  We’ll end this episode by panning out from the molecules to the meta picture of insulin by going over 3 key substances that trigger insulin resistance and how these are linked to lifestyle. 

This episode will explain the important interaction between insulin, insulin receptor, and a key protein called IRS (insulin receptor substrate).  I'll use a simple lock and key model to simplify how these molecules interact and serve as an important doorway to metabolism.  Understanding the information in this episode will move you closer to gaining deep insights into future episodes where I discuss the molecular and lifestyle basis for insulin resistance and related issues with metabolism.  

Find out why I call rumination pre-depression/pre-anxiety.  Identifying and solving for rumination can have a significant impact on reducing much of the suffering we experience on a daily basis.  In this episode I describe the science of rumination, common rumination movies that play inside our head, and tactics for terminating rumination before it spirals out of control.  

Beta cells are the insulin-producing cells in our pancreas and their durability is a key factor in promoting longevity and optimal health.  In this episode I use the battery analogy to explain how beta cells work and what actions you can take to preserve your beta cell battery life which helps prevent/reverse diabetes and other chronic health conditions.  I also discuss ways in which you can estimate your beta cell battery life and what role certain conditions have on beta cell life. 

Glucose transporters (aka Glut) are a key protein that shuttles glucose into cells.  Understanding Glut helps you understand how your body transports and utilizes sugar, and how you can impact your glucose metabolism through lifestyle changes like exercise.  We'll use some clever mnemonics to keep the different Glut subtypes straight. 

This is the first of a series of episodes that digs deep into insulin's actions and uses what I call the "mango cell model" so you understand the key components of cell structure.  I'm also going to introduce a key glucose transporter called GLUT and end with my opinion about mangos and fruits in general when it comes to metabolic health. 

Your time is precious and there are a ton of health podcasts out there already.  In my trailer I discuss how this show might add some unique value and give you a totally different angle on learning about metabolism and health science.