0:00 I'm a practicing gastroenterologist. Even though people think that I'm a full-time YouTuber. You'll be amazed that the gut bacteria is the underlying problem for everything. You name a problem, mental health, cancer, obesity, gut bacteria. Effectively, you are the god for the bacteria inside you. That's why they call that as a second brain. I always tell my patients is that when you tear a piece of a package, you are tearing a piece of your gut. Damn... What is happening is the biggest epidemic, Ranveer, is not COVID. 10 years from now, it's going to be multi-drug resistant bacteria. People are going to die right and left. It's called super bug. There's a whole universe inside you. Wow. So if you basically come out of a vagina instead of come out through a C-section, you're technically healthier for life in some ways. Pretty much. People think that social drinking is okay.
0:45 When I grew up, if my father knows that I drink a sip of alcohol, I'll be outcasted from the community. In US, if you say I don't drink alcohol, they come to you and then say, is everything okay with your health? Liver is also an organ that cannot keep on saving you for the rest of your life. Wow, I love this conversation. As I'm heading into my 30s, I'm noticing that both myself as well as all my friends of my age are more and more concerned with health. This year, I've been really enjoying the biology-based conversations, we've been having on TRS. It's been great to hear from medical professionals about their own areas of expertise. Today's guest, Dr. Pal Manickam has spoken in detail about our digestive system. Now, you might think that your digestive system is a very tiny part of your body.
1:33 It's just one function. But in truth, it's related to everything that's happening in your body. And in many ways, it's related to what's happening in your mind. We have addressed how mental health is also related to your digestive tract in this particular podcast. But you'll be shocked at where this podcast ends up going. You'll be surprised to know how important your digestive system is for the rest of your life. So I suggest you watchout this video if you're concerned in overall health, if you're a biology enthusiast like me, or if you simply enjoy in-depth scientific podcasts. This is Dr. Pal Manickam with an epic episode of TRS. [♫♫♫]
2:28 Dr. Pal Manickam, welcome to TRS. How are you? Good, sir. Good. Thank you for having me Ranveer. Okay, where do we begin this medical conversation? You know, that medical conversations are being loved by our audiences lately. Oh, good. That's good. That's good for me. Why do you think people have suddenly gotten so deep into biology? Maybe after COVID? Yeah. People care much more about their body? I think so. I've noticed a trend among younger people where they prioritize self-care, which is great because it aligns with my channel's tagline. My uncle is very passionate about biology, but he's grown the passion recently. And every time I meet him, he'll give me biology inputs. He'll say that, listen, you need to eat this for gut and that for gut. And it reached a point where
3:13 he was very worried and he was telling me, and I told him that I know a lot of these things. He's like, no, how do you know? I don't think you know. I explained to him that I think his friends and peers may not be as interested in biology and health. However, as we reach our thirties and our bodies start to age, Everyone talks about health. Everyone talks about the right way to live, etc. Right. Do you see this as the truth, like a bit of a generation gap in terms of how the older generation looks at health? No, absolutely. If you look at it, the average age population that people come to me for any problem is only at 45. You will not believe in US where I'm practicing. People don't take care of their health until 40 years of age.
3:58 Really? And it's only during their annual physical exam that they find out about their high cholesterol levels and what to do about it, right? When I explain to patients that the harm was done a decade ago and it's time to start the healing process, it's a common occurrence. So elevated cholesterol levels is the most common thing in the US? Yeah, or elevated glucose levels. And it is extremely common in Indian immigrants. Extremely common. And I'm a gastroenterologist, I see, the bread and butter of my practice is doing colonoscopy. Colonoscopy to look for colon cancer. Any precancerous colon polyps, these are like small growth like projections inside the colon, I do an endoscopy from your anal orifice to go inside all the way into your large intestine,
4:45 and then see whether these growths are there. And if it is, we remove it and then prevent colon cancer. This is my bread and butter. I do like 20 of these procedures every day. Okay. I've been doing this for the last eight years. I'm actually not too familiar with everything that a gastroenterologist does. Let's begin with that. I think it's actually a very key aspect of modern day health. They say that the gut health is actually related to your mind, your mood, etc. as well. And if you're saying that cholesterol related problems, elevated glucose related problems are this common, Correct. I want to know more. For people my age, for people my parents' age, what's up, tell me everything about gastroenterology. So the reason I said about the colonoscopy is the average age I see is 50 years of age. Okay. In US, everybody when you turn 50,
5:32 I will give them the birthday gift as colonoscopy. Even healthy people? Healthy people. Really? Because it's covered by insurance. And it is a mandatory thing for us to screen for pre-cancerous colon polyps. And we do this every five to 10 years based on what we find. So there is such a shortage of gastroenterologists over there because there are 350 million people in US. And the reason we do that is there's increased risk of colon cancer because of their dietary habits. You know what scares me about this? Shoving a camera up my butt. And I love it. [Laughter] But as a, as a non-doctor, as a patient knowing that I'll have to do colonoscopy at some point in my life scares me, man, I don't want to put anything in my butt. The point I was trying to make was because, you know,
6:19 I told you that people are having elevated colestrol and everything. At age 50, you are not supposed to see any kind of pre-cancerous colon polyps in Indian immigrants. Okay. But because of this health deterioration, which they have not put the effort before, I'm seeing a lot of pre-cancerous colon polyps I've never seen before. And this is a very typical demographic. 25 years, they came to US, 20 years of hard work, stress, a lot of things, and they settled in life. Their kids are like, you know, 12, 10, and it's time for their colonoscopies, right? So when they do it ideally, you follow a mostly vegetarian diet like we do here, right? We don't eat much beef or pork when we were growing up. So the likelihood of pre-cancerous colon polyps is supposed to be low. I think India is actually becoming really healthy now.
7:06 You're familiar with ''Ram Ram Bhai Sareya Ne'' You know, that culture has now reached the interiors of India and people are becoming more health-conscious. That's why these conversations are quite interesting for the end user. But there's still a lot of education required, the scientific education related to your health. At this point in my life, I have to consider things like cancer, aging, and other lifestyle-related concerns. So let's let's go back to that. You spoke about elevated glucose levels and elevated cholesterol. It's happening mainly because Indian diets are not balanced. Absolutely. Yeah. Even in India? Even in India. We eat too many, too much carbohydrate. Correct. That's effectively what it is. Too many carbohydrates. And if you if you look at it, and we do research on gut bacteria, right?
7:54 So we that's what I do. I was involved in mice research. I'm a practicing gastroenterologist, even though people think that I'm a full time YouTuber. So what we do is we go to the research lab and work with two groups of mice. We conduct research You will be amazed, by the amount of findings that we are seeing. That the gut bacteria is the underlying problem for everything. What do you mean everything? Name a problem? Mental health, gut bacteria, cancer, gut bacteria, obesity, gut bacteria, in general. Let's go into the ABCs. What is gut bacteria? So when we say gut, people think that it is stomach most of the times. So it is not stomach. It's mainly the small and large intestine.
8:42 It's amazing to think that each person, including you and me, has 100 trillion bacteria in our gut. That's more than the entire world population of 8 billion! Okay. And even 100 trillion is 1 followed by 14 zeros. And the unique aspect is this 1 followed by 14 zeros bacteria is completely unique to you and to me. It is like a fingerprint and nobody can ever replicate it at all. Okay. And this is something that you have been feeding right from when you were born. 100 trillion, you said? 100 trillion. Okay. Okay. It's a completely lined up. Imagine that it is from your oral cavity, all the way to your anal orifice, like a hundred trillion fire cracker in Diwali.
9:30 It's being arranged like so close. Okay. So effectively, you are the God for the bacteria inside you. You are the God. You are the God. And that's why they call that as a second brain. So there's a whole universe inside you. It's completely different. It's like a Marvel universe over there. Why is it called second brain? Because all these bacteria needs to be monitored, whether you are getting good bacteria or bad bacteria. What is happening? You know, whenever you eat. For example, you know, you serve me nuts and cashews now, right? When I eat cashews, the good and bad bacteria have to interact to determine if it's beneficial for me or not. It's a continuous monitoring process. What do you mean interact? So the the good bacteria and bad bacteria aligning the intestine
10:18 constantly monitor what you're eating. Alright, and those chemical mediators are secreted along the intestinal wall. These molecules then seep through the intestine wall, enter the brain, and influence your decision-making. OK, I'm trying to understand this better. So please correct me if I'm saying something wrong. So when you say "good bacteria," you're talking about things that are actually good for your health and gut, maybe even improve digestion. Correct. By bad bacteria, do you mean germs of some sort? No, everything is germ. So the concept is that these bacterias, even though always we have blamed bacteria as a bad thing, right? We know infection, we give antibiotics and we don't want bacterias. But that's not true. Throughout from ancestors life, we have had a symbiotic relationship with bacteria.
11:05 What we mean by that is we need them. They need us. They live inside us and we need them in order to digest our food. Correct. Which we are not given genes at birth by God for not digesting certain food particles like complex carbs. OK, so for example, I'll tell you an example. So let's say that you are eating a complex carb. OK, simple sugar. So let's say, you know, having a maida biscuit, you eat it. It goes into your stomach, acid being secreted. So there is no organisms in the stomach that much because it's all acidic. Then it goes into your small intestine. So the small intestine is the site of absorption. So it absorbs everything. Oh, good. I love simple glucose. Oh, I love biscuit. Everything good. And then when the biscuit goes down to the large intestine, there is nothing for the bacteria to eat.
11:51 Bacteria doesn't feed on simple sugar. So what happens is that the bacteria start attacking the walls of the small and large intestine Ohh.. because they need food to survive. So when you are creating a disruption in that barrier, that is where the problem is happening. That is right at the molecular level. We are looking at the state of the art heart attack device that we are inventing, right? But the bottom line problem was at the lining of the intestines. And that is why they say it is the second brain, because all these nerve supplies talk to the primary brain as well. Got it. And then it makes you do a decision. Let's say you want to eat this. Maybe it's not you. It's your bad bacteria that wants it. Let's talk about the nervous system a little bit.
12:39 So, your brain, spinal cord, and nervous system are all made up of the same type of nerve tissue. Correct. Are you saying that your gut has more nerves connected to it? Yes. Gut has something called enteric nervous system. This is called central nervous system. And the gut has enteric nervous system. And those neurons are sometimes even more powerful than your first brain. Why? Because they constantly interact. It's a two way communication. The information goes from here and the brain sends a communication over here and make sure that, OK, so this food is good for us. Let's make it hold for longer. Let's absorb all these nutrients. And this food is bad for us. OK, let's just excrete it as soon as possible.
13:25 You will not believe how much amount of impulses that is happening in that small connection. Basically, when Virat Kohli is playing a cover drive, he's played that cover drive so many times in his life and perfected it. Which is why when it actually happens in an international game, it happens like a machine. It happens automatically. But how often does Virat Kohli have to play a cover drive versus how often does Virat Kohli have to eat? That nervous pathway, which allows him to play a cover drive, is very well worked because he's a professional athlete. I see. I see. But the nervous pathway for food and a human being is so much more important. The food and eating is one of the most central aspects of human life. That's probably why the body has created such a strong nervous pathway between the gut and the brain.
14:10 Yes, because it's such an active part of our life. Yes, absolutely. Absolutely. Please correct me when I'm wrong. I'm just trying to understand. No, no, you're right. I tell an analogy. It's like, you know, in Bhagavad Gita, I would say our gut is Lord Krishna and our brain is Arjuna. Really that? It's that big. Because our gut has its own dharma. And if we replace the Lord Krishna chakra with parottas, then Lord Krishna will tell Arjuna that some adharma is going on in the gut. You need to fight against your own body. It's how deep that is. It has to be a smooth, transient connection. And the most important thing is, it's not something that happens in the middle of your life or something like that.
14:57 It happens right when you are born out of your mother's vagina. Vaginal delivery. Do you think that a neuroscientist or a neurosurgeon would also say the same thing? Neuroscientists always say that, oh, you know, brain is the biggest thing. Because, you know, it has a master plan. Our gut might not be able to do that kind of master plan like brain. But the gut has a stronger potential to influence the brain in terms of your decision making. For example, so let's say that you're craving for something, right? I was addicted to dairy milk. The reason that I was addicted to dairy milk is because whenever I eat dairy milk, my bacteria in my intestines is growing according to what my dairy milk wants.
15:47 Right. So in due course of time, there is no good bacteria at all. Then that bad bacteria keeps on multiplying and it secretes dopamine right at the junction of the intestine. And that dopamine pierces the wall, gets into the blood, goes into the brain, secretes dopamine. And I feel that craving satisfaction. Then what I do, I crave for even more. So this is a vicious cycle. And I keep mentioning that this is something that I did to my body on a due course of time. It didn't happen overnight or it didn't happen a month or two. OK, so much to explore here. But let's go back to good bacteria and bad bacteria. So your good bacteria is there in your gut since childhood?
16:33 Since when you're born. So I'll tell you, I'll take a minute to explain this. So you take two deliveries. OK, one baby is born through normal vaginal delivery. The other baby is born through a C-section. OK. And we did research to find out which baby has a good bacteria. Right. When babies are born, there is a lot of space for good bacteria to grow because their small intestines are about 22 feet long and their large intestines are about 5 feet long. There is so much real estate fresh. There is no microbes, nothing. When the baby is born through vaginal delivery, it swallows the normal vaginal bacteria that goes into the stomach that creates that triggering cascade response so that all the good bacteria
17:20 gets the first place. Damm.. The same thing if you go to caesarean section, when you take that baby stool specimen and look at the microbiota, they have only the skin microbes of the mom when we are taking it out. And part of the microbes is based on who's taking the baby out, like the people who are handling the baby. You mean the gynecologists? The gynecologists, the caregivers and the environmental bacteria more than the normal vaginal bacteria. So I'm not saying the C-section is bad. So please don't take that as the example over here. But what I'm trying to say is it starts right from the birth. OK.
18:05 And then there are multiple studies also showing that, you know, if you look at kids who are born through C-section and you follow them over time, the likelihood of obesity is slightly increased in patients who are delivered with C-section. And this is a very controversial finding where some studies have refuted it, some studies have supported it. But bottom line is their microbiota, their gut bacteria is definitely slightly different than the normal one. For life. Unless they change by implementing good gut health techniques during the process, during their growth, which is dietary. Dietary, you know, exposure to, you know, like exposure to dirt itself. OK. I mean, that's a different story.
18:52 We'll talk about it as well. We will come to that because that's actual call to action. Correct. Actually, we can teach people through the show. OK. I want to say something about exercise. Everyone has this idea in their head and it's so difficult. But the truth is, there is an exercise format that your body and mind will like automatically. For some people, it's dance. For some people, it's weight training. For some people, it's running, running. For some people, it's Hatha Yoga. For some people, it's sports. For so many people, it's sports. But you just need to take that deep dive into whatever it is. In that first month, push yourself for one month. It'll help you through the rest of your life. Correct. Because hear these conversations, movement exercises, that important. You have to prioritize it. Literally, the worst mistake I've done in my entire life was
19:40 pre age 16, didn't focus enough on exercise and post age 22. Prioritize money and fame over health. Maintain my health for the sake of how I looked. But only now when I've switched into religiously playing sports is everything getting fixed in my life. My mental health is so much better. I'm so much happier. I sleep so much better. I look so much better, I feel so much better. Great. But you need to motivate yourself, find a social group, start weight training, engage in sports or any physical activity that you can, and ideally incorporate weight training, stretching, and sports into your routine. The combination of these in different proportions, depending on your life can really help you, but at least do one of them, if not all. Now let's get back to good bacteria and bad bacteria.
20:26 Piggybacking on the point is that exercise also modulates the gut bacteria. If you exercise, you increase the likelihood of having more good bacteria and decreasing the amount of bad bacteria. I think when it comes to health, it boils down to the basics always. That exercise, eat clean, you'll be all right. Keep it simple. Yeah. People overcomplicate diets nowadays. People have too many deep logics about diet and you'll often see that the people who are not very healthy, complicate diets a lot. I've seen this so much, especially with like the older generation. They have either not lived in a healthy way for a long time. Or, you know, I have just discovered health. Then they'll say no, you need to eat this. Don't eat this in this way at this time.
21:11 But the truth is just eat clean, eat raw, eat organic, you'll be okay. We'll come to that later. Yes. Let's get back to good and bad bacteria. What is bad bacteria? Is it like the bacteria that you get by drinking unclean water? No, not really. That is a really bad bacteria. Okay, so let's just classify this. Let's take Marvel Universe, right? Sure. So we have like, you know, Iron Man, Hulk, Spider-Man, all these are like good guys. And we have the Thanos. Okay. And Thanos also have these like small, small bad guys associated with him. Our body will recognize Thanos, and then we'll make sure that Thanos is not being activated. Okay, so that is taken care of by the immune system lining the intestines. So let's say you are eating a pav bhaji and it is contaminated.
21:57 It goes inside and they know it is Thanos. Okay, so let's just stimulate the immune response and then it creates a cascade of events and they fight against Thanos and Thanos is done. That's when you have 2-3 days fever, diarrhea, nausea, and vomiting. And after three to four days, you'll be back to normal. Because all this immune system doesn't happen with your brain. It happens at the lining of your small intestine and large intestine. It's called pious patches. Are you talking about just fighting dietary germs or anything? Dietary germs is the main thing because that's a pathogenic oral ingestion of that bad bacteria. The same concept happens when you are exposed to let's say COVID virus or any other pulmonary lung bacteria. The same thing happens within the lungs fighting against the bacteria.
22:44 This is for an oral thing that I'm talking about. Okay, got it. And that is the baddest of the bad, right? But what happens is because of our dietary style. Okay, so let's say that we don't have enough fiber in our diet. Okay, remember I told you that the bacteria needs fiber. Okay, so let's say a baby is born through vaginal delivery, has a very good gut bacteria. How do we preserve the gut bacteria throughout is by just giving them fiber, fiber, fiber. If you consume a lot of fiber, which includes fruits, vegetables, and other sources, the good bacteria in your gut will keep increasing, while the harmful bacteria will decrease. Then this good group will take care of you for the rest of your life. They will fight against any kind of bad guys.
23:31 Okay, but what is happening in during this industrialized when the last like 10-15 years mainly, this thing has gone down with all this artificial processed foods and everything high calorie, high fat, low protein, low fiber and this thing goes down and this thing goes up. This gut bacteria is malleable, which we can change it, but we need to feed it properly. If we feed bad things, the bad bacteria will grow. If we feed good things, good bacteria will grow. So this is a constant seesaw play that we are trying to adapt so that we can lead a longer lifetime. Okay, but you spoke about how good bacteria and bad bacteria interact. You said the absolute villainous bacteria is germs, which will give you infections.
24:16 Infection, like Salmonella typhoid is an example of a baddest of the bad bacteria. But you're saying inherently in your gut, there is also something called bad bacteria. Inherently, correct. You get a mix of both good and bad gut bacteria. That bad bacteria is there because of our modern day dietary lifestyles. And also exposure to environment. But if your good gut bacteria is more, it has the capability to control this environment. It's not 50-50? It's not 50-50. No. So in a very healthy person, someone who takes care of their body, etc. Say someone who's living also outside a city, you know, rural India, eating very healthy, eating clean, etc. What is the proportion? We conducted research on how our ancestors lived
25:05 current modern-day living. We studied a tribal community in Tanzania called the Hadza tribe. We conducted extensive research on the microbiota in their stool and found that they have 1600 diverse bacteria. as they do not grow animal products or farm vegetables. They hunt. That's where their general thing is. And they are successful in the hunting one in every 20 days. And in between what they eat, they eat plants, you know, complex tubers, beets, nuts, I mean, fruits and tubers, where the complex carbs is so much and coming back to the previous point that we discussed that it reaches the large intestine,
25:50 and they are feeding the good bacteria, keep going, keep going. So whenever you eat something, there are two things, you feed yourself first, then you need to feed your gut bacteria. So when you look at them, it's 1600. When we did the research on common American man, it's only 1200. And this thing is passed on to generations, we have lost 400 good bacteria, and there is no way to revive it. And my real scare is, this thing is passed on to generations. And if it's similar to deforestation, you know, where we are cutting down trees and it affects the next generation. 25% of trees are gone, we're cutting down trees, and 50% are gone, there's no way to revive them, right? But with gut bacteria, if you're conscious enough,
26:36 and then replant the trees, replant the gut bacteria, it will be such a wonderful thing that we're doing for our future generations. There's actually my favorite YouTube channel is this channel called best ever food review show, where he goes to different parts of the world and also shows the culture of the place. So he had done a pretty graphic video, I think with the Hatsa tribe. It's not an easy watch, especially for vegetarians. It's, it's something intense. But what you said that they get a successful kill once in 20 days. In those 20 days, they're just exploring, collecting things and eating, which brings me to the process of evolution. According to science, archaeologists claim that between 200,000 to 300,000 years ago, that was the first time Homo sapiens roamed around the earth.
27:23 Okay. And I've talked to some archaeologists who think that we say it's two to three lakh years ago, based on the bone fossils we've found from that period. It possibily could be longer than that. Okay. But my point is that we know for a fact, that only in about 10,000 BC or so, did we really start settling down in villages, etc. I love history. Now, two lakh minus 10,000 years or minus even 20,000 years, okay, to be safe, is 1,80,000 years. That means for 1,80,000 years, all of us were living like the Hatsa tribe. All of us were hunter gatherers. Correct. And our bodies are used to that. When nature has fed us, helped our good bacteria.
28:09 And nowadays, we often find ourselves impatiently waiting for a burger at McDonald's or sitting in Pizza Hut eagerly anticipating our pizza. I was about to say there is no diabetes, obesity, heart disease in Hatsa. How come? And they eat honey. People say that, you know, you don't eat honey, because honey is like rich in carbs and everything. But they have developed a gut bacteria balance that helps prevent communicable diseases and greatly reduces non-communicable diseases. One of the most beautiful and impactful books I read in my life was Sapiens by Yuval Noah Harari. He actually draws out a picture of what hunter gatherer life was like. And one of the key features was that the world was your buffet. How you go to buffet and you see different foods.
28:55 When you go out into the forest, you can see mushrooms growing, fruits on trees, edible leaves, and even hunt for protein. You will see something else and you will eat that. You'll see raw nuts growing, you'll see some other kind of berries. And you're exploring so much that you're actually taking the best bits from nature. That's what our bodies are meant to do. Absolutely. And while exploring also working your body because of movement. Absolutely, absolutely. That's actually what your bodies are built to do. But again, that's not realistic, because even the viewers or listeners of this podcast are likely sitting in their cars or at home. And this is our life now, in a concrete jungle. So all we can do is think about the future. You know, absolutely. And the present also,
29:41 which is why I want to bring you back to 2023. Do you have any thoughts on what I just mentioned? Speaking of the Hazda tribe, another interesting fact is that after a hunt, they would finish their meal by sunset because there is no light. The Hazda tribe finishes their meal at sunset, eats a heavy meal together, and then naturally produces so much melatonin that they sleep well throughout the night. All the growth hormone, you know, every cell in our body has a sleep-wake cycle. Similar to how you go to bed at night and you wake up in the morning, every cell has a sleep-wake cycle. Active digestive hormones is from sunrise to sunset
30:27 and the trigger is the sunlight. Your sunlight comes in the morning and then you wake up and then all the digestive hormones are active and then at sunset, it dies down. For instance, when you eat a samosa, it enters your stomach and needs to be broken down by acid. How does this happen? The cells open up, projections come in, acid is poured, the food is digested, and then comeback. So, who's gonna shut down those cells? You need a growth hormone for repair that kicks in when you're asleep for at least 7-8 hours at night. So, when melatonin is secreted during a good night's sleep, it helps repair all stomach damageand you're ready for the next day. Basically, boils down to the basics again. Eat clean, exercise, sleep well. Returning to your point about modern day life, it may be difficult to incorporate physical activity and clean eating,
31:16 but making an effort to eat early can be done. If you can put a concious effort into it. While the sun is out? Yes, eat while the sun is out and when the sun sets and that's it, your dinner time should be done. And I have a wonderful research study to share regarding this. I was part of a research study where we fed pizza and burgers for example, to a small group of mice, from sunrise to sunset, which is from 7am to 7pm. And then we gave the same pizza and burger from 7pm to 7am to a different group of mice. Three months later, we examined the results of this study and were surprised to find that neither group had gained any weight. But the most important finding was that when
32:02 these mice were fed pizza between 7pm to 7am, their cholesterol levels, glucose levels, and insulin resistance all increased after three months. And when you follow this for six months later, that's where the weight gain came in. So, if someone is gaining weight, the harm has already been done beforehand. By simply adjusting the feeding time, the weight can be lost. And that was an eye-opener for me and then I started using that technique on my patients with fatty liver. And you know, fatty liver is fat deposit in the liver whenever there is a belly fat. And I told them, you can eat whatever you want initially, I understand you're a busy professional and can't follow all my advice, but try to have your dinner by 7:30pm or 8pm at the latest.
32:49 This is a wonderful technique. I think I lost weight, so much weight and everything. And then I started doing that on myself, then I lost weight, then I started imparting that to all my YouTube subscribers. And I see this big change in the pictures that they are saying before and after. And I said, I think that this is one of the, this is not the holy grail, but I think this is one of a very sustainable method, which can be easily applied in your modern day practice, if you just put this thought process together as a family. Yeah, you know, the reason I get bored of giving people diet advice through the podcast or through my old fitness and health videos, like Beerbiceps was started as a fitness and health channel. I got bored because actually, it's really simple.
33:34 I'm just going to be repeating the same thing. So there's a lot of people who are probably unhealthy right now listening to this podcast and taking down notes. But the truth is, they've already heard all these things in their life. They've just not followed it. Okay, which is why now I want to talk about my love life. Thank you. Tell me. How can I help you? That's an interesting conversation. Okay, love life. So there's a girl I like. And I'm actually a pretty healthy guy. Honestly, I get my blood reports done everything. But she said that, you know what, man? She's a spiritual girl. So I've hit the mark there. That should be a first checkbox. Yeah. So she's a spiritual girl. And she told me that you're healthy and all.
34:20 You're spiritual. But you need to fix certain aspects of your life. And if you do that, then I'll consider dating you. Okay. I'm not even making this shit up. That's what's sad. Is she your subscriber? No comment. So now, she's someone who sleeps at 10, wakes up at four or five. And that's always been my dream. I think in terms of health that is the next stage for me. I've already made progress with my diet and exercise, but there's still room for improvement in this area. During COVID, there was a long phase, where I used to sleep at 6am and wake up at 2pm. Surprisingly, I was quite productive during that time. I don't know why. All my life I've been someone who stays up at night and I either study or I read or I write or something. Moved to this house in Versova.
35:07 And my studio is in my house. Okay, so it's very convenient for me to begin shooting at 11am, etc. It's convenient for the guests, my whole day goes very well. Correct. So I was forced to start sleeping earlier. So from 6am, I came down to 1am. And now I wake up at say, nine, 10 o'clock, get good sleep. And then I wake up and I do these podcasts and then I live out my day. If I could adjust my schedule from waking up at 6am to 1am for the sake of my career, I am confident that with a bit of determination and focus, I can easily switch it from 1am to 10pm. And that's what long term exercise and diet has also taught me that it might seem difficult. But as Dr. Andrew Huberman says, and he's become the legend of the world of biology online,
35:53 like his podcast has blown up. Everyone I know who's into health listens to Andrew Huberman. He says that the single biggest deciding factor in bringing change in your life is your own focus of your mind. If you put focus on the problem, put hard work, you'll be able to switch up and you'll be able to change your brain chemistry, you'll be able to change all your neural patterns to actually fix your life. But it has to come from your heart. Inside you need to feel that determination to change it. This girl is beautiful. [laughter] So your going to change it. I will change it. It's too early right now. But I think I found the one so good. It depends on if I can fix my life. So make sure that you have good gut bacteria as well. So that your offsprings are pretty good. Yeah, she's really healthy.
36:39 I'm really healthy. So, another thing I always mention is that when I was growing up, people used to match horoscopes for marriage. Do you believe in that too? As for me, it depends on the girl. Okay, so for us, when I grew up, astrology was a top priority. Okay, so be to a point that we actually bribe the astrologer. Okay, please, Uma, I like this girl, please do something and match. So as a gastroenterologist, I say that in addition to astrology, you need to look at the gut bacteria as well. So if I have to open a website, I will not say matrimony.com, I will say guts.com. And then I will say the tagline is, marry me if you have guts. But there's science behind what you're saying. Absolutely. One obvious logic is that the mom's gut bacteria will have
37:26 an impact on the baby's gut bacteria for sure. Very obvious, through pregnancy, through childbirth. How does the dad's? The environmental exposure, basically. So let's say like I shake hands with you. Okay, so our hand has more bacteria than our whole cells. Okay, so it's exposure. So when you're getting exposed to pets, when you're touching dogs, and dogs are transferring the good bacteria to you. So it's all about the environment. Dogs also have good bacteria. Yeah, good and bad bacteria. So there is a study that said that children who grew up with dogs have less asthma. And the risk of allergic disease is slightly lower in those kids. And again, it comes back to the dog is going outside playing with dirt and comes back again. And the kids are playing and the transmission of bacteria is happening.
38:12 So that kid is getting exposed to a wide variety of microbiums that you will ever even think of. Going back to what I was saying earlier, nowadays with our modern world, kids don't play outside in the dirt as much anymore. And we are playing dirt, not actual dirt, the dirt video game on the kids on the iPad. So when you play in dirt, again, the same amount of microbes that goes in, and it is always better not to be overly sanitized. There's a kid who lives in my building. Sometimes on weekends, if my friends are not playing football with me, I'll just take my own football downstairs. And I'll tell him to come downstairs. And I'll play a passing game with him. Okay, he's an athletic kid. I read online that playing barefoot can improve ball control,
38:59 since it helps your nervous system get used to controlling the ball. I told him to take off your shoes and play with me on the grass because it feels great. And you get major grounding because when you play barefooted on the grass, he said, I don't want to bro. It's dirty. The mud is dirty. Oh my god. And I was looking at him like, hmm. I've heard that before. I see. I used to have a lot of relatives who used to tell me the same thing, mud is dirty. But I've had many guests on my show from diverse backgrounds who have talked about how great and beneficial mud can be. And you're a doctor who's saying the same thing again. Let's talk a little bit about dirt, mud. What's the deal? So there's something called hygiene hypothesis. As a gastroenterologist, I see a lot of autoimmune diseases these days,
39:46 such as inflammatory bowel disease, ulcerative colitis, and Crohn's disease. Essentially, this means that your body thinks that your colon doesn't belong to you. Your colon is foreign, it shouldn't be in your body. So all this immune system starts activating up and then starts eating up your colon. This was not common in India at all. And now 25% of my population is Indians. And the reason for this is that when we go back, some people say genetics or exposure, but one of the reasons is the hygiene hypothesis. We tend to be overly protective of our children and our Indian culture, where anything can happen to me, nothing should happen to my kid, correct? But by protecting them overly and not exposing them to dirt, not letting them play with dogs and everything.
40:34 The population of bacteria that they are getting exposed gets decreased. And this bacteria interacts with the immune system. Our immune system is hyper, Ranveer, okay? It's like me. It keeps hyper, it's always on the go, has to do something, It keeps taking the bacteria out and then says, is it good or bad? Oh, no, good? Okay, keep it. Bad, no. You need to keep on giving some good things to the immune system to do. If it is bored, it starts eating up your organ. Okay? So when you are playing in dirt, it says, oh, good, bad bacteria, good. We'll discard. Good bacteria, we'll keep it. But when you are an overly scientist environment, the immune system doesn't have anything to do. What will it do? Then it starts thinking idle madness. Devil's workshop.
41:20 So it started working in a devil's standpoint. It starts eating up your own, I strongly believe that this is the primary cause of the rising occurrence of autoimmune diseases such as rheumatoid arthritis and celiac disease. What is colitis? Inflammation of the colon. And that's the thing, people often associate autoimmune diseases with the immune system thinks that your colon doesn't belong to you. Because there's nothing to do. Or your immune system, your gut bacteria is basically bored. Right? Your immune system is bored because you're not giving gut bacteria to them. You know what I'm saying? Some people even say that street food tastes better because the sweat of the vendor falls into it.. That sweat is basically protecting you from autoimmune problems.
42:05 Correct. Is that what you're saying? It could be. Like in a way. In a way. But that doesn't mean that, you know, you can go on, you know, like very, let's say hospital environment, right? You drop the chocolate on a home floor. It's okay. Three seconds later, you eat it because it's your home environment. That microbes is not going to be that Thanos. It could be like smaller bad guys, but your gut bacteria will take care of it. But at the same time, you're giving work to your immune system. You are providing a wide variety of bacteria. It's all good. The same chocolate, if it drops in the hospital setting, I will not even go near it. Right? Because then the actual Thanos might come in and it could be antibiotic resistant. We don't even know. So it is a fine, delicate balance. And especially for kids playing in dirt, best thing ever.
42:51 Okay. I'll tell you what, again, I'm going back to my life. I'm trying to make this relatable for the audiences. I'm from a family of doctors. My mom literally never let me and my sister eat street food when we were kids. In college, I had my first street food experience, and I used to get sick a lot back then. But now I don't get sick anymore even if I eat street food. My hypothesis is that my gut strengthened up between the ages of 18 and 22 in college when I started eating street food. I've noticed that my mom gets sick often, even if she eats Like she even eats restaurant food once or twice a week. It's harsh on her body you know. She's not able to like take it. Of course there's an age factor, et cetera. But I think that growing up in India where we grow up, our guts become much stronger
43:36 compared to someone who's not used to the local food and gets sick easily. The moment they eat chutney or the moment they drink water, something happens with their stomachs. Correct. Correct. So you want to say anything about that? You're trying to find an argument to support yourself for your mom? [laughter] Yeah. See, mama. Auntie, he's asking me to say yes. [Laughter] But you know, maybe in 18 to 22, that's where you had your change of lifestyle as well. Yeah. Right. You know, you exercise more. You started doing this lemon chicken. Maybe protein was more, fiber was more. And maybe your gut bacteria started to change. And that is something that you might have to think through as well. Okay. But what about this outside eating thing when you're,
44:21 and we'll get to a whole section on diet, but. Street foods. Yeah. Or just generally living in India, living in an Indian city, you are exposed to a lot of rubbish. Absolutely. On some level it's harming you, but on some level it's also. It's good. It's good? It's absolutely good. Because the exposure to the microbes you'll never get in US. How do you get in US? There is, you know, the infectious diseases that is available. I mean, that is prevalent in India. It's not even close to what is available in US. Okay. And yes, it is bad, right? You know, let's say severe tuberculosis, that's bad. But all these small, small viruses, it's okay to be sick. And the biggest thing is, please, please, let me look at the audience and say, if you are having a fever,
45:07 please don't take antibiotics right and left. Okay. Only if it is absolutely indicated. Nowadays, even when there is IPL fever, they're taking antibiotics. What does antibiotics change in your gut? You remember the 100 trillion fire cracker? Yeah. Right from the oral cavity to the anal orifice, 50% is gone. It blasts your digestive system. It blasts the bacteria, good and bad, both. Okay. Okay. And it takes a lot of time to repopulate again. How long? Maybe, it depends upon individual, right? Sometimes if you have a good lifestyle before, maybe like six weeks, eight weeks. Sometimes if you're bad to start with, it may even take three to six months.
45:52 It's that bad. Usually when someone's prescribing antibiotics, they also give a probiotic, I believe. How much does a probiotic help? Probiotic, that's a very difficult story, but that doesn't help that much. That doesn't help that much. That's the story. Yes, it does help a little bit, but not that much. Remember 100 trillion, 50 trillion is gone. Probiotic is not going to replace 50 trillion. Okay. The better way is to, if it is a viral fever, you don't need antibiotics at all. I did a reel on my channel that I went to a pharmacy store in Chennai, and I said, I need Augmentin. And Augmentin is a stronger antibiotic, right? This is not Amoxicillin. Amoxicillin is the number one antibiotic that you give for any pneumonia or anything like that, right? Augmentin is for an antibiotic
46:37 where Amoxicillin is not working. It's an even powerful antibiotic. So Amoxicillin kills 50 trillion. Augmentin might kill 75 trillion. In US, you cannot even get Amoxicillin without a prescription. You cannot walk into a store and get Amoxicillin. Here, I showed to the audience that you can even get Augmentin easily without a prescription. Okay. What is happening is the biggest epidemic, Ranveer, is not COVID. 10 years from now, it's going to be multi-drug resistant bacterias. Yeah. You're saying there's going to be new bacterias, new diseases that come up. A bacteria that is resistant to antibiotics. It's called Superbug. It's become resistant to antibiotics because human bodies just don't accept antibiotics anymore.
47:25 So what happens is when we take antibiotics, the bacteria is smart. Oh, so you are... It's like, you know, Ramayana, Mahabharata, you have a bow... Oh, this is a bow and arrow that's coming. I know, I have a shield now. So Amoxicillin, I know what to do. So the bacteria forms a shield. So your bow and arrow is not working. So then what do you do? You go up and then you bring a Gada and then you just break open. Then now there's another shield for Gada as well. And there is this patient, 35-year-old pneumonia patient. Pneumonia. He died. He had likely received a lot of antibiotic treatments, causing his body to become resistant to them. And this bacteria called Acinetobacter baumannii. We tried so many antibiotics, nothing worked. And it is not that he did it.
48:12 It might be other people. So you taking an antibiotic for yourself is not... People may say, it's my body, I can do whatever you want. No, that's not true. You are damaging the community because that antibiotic resistance is going to get out of you to somebody else. What? So the bacteria that is in your body, which is resistant to all these things, can get transmitted to other people as well. Wow, that's crazy! So if one family member is consistently taking antibiotics, it can impact the gut bacteria in their children's and spouse's bodies. And then they can transmit it to other people where then treating them is going to be very difficult. So it's just a ticking time bomb. A ticking time bomb. And there is this notion in India
48:58 that only if a doctor gives antibiotics, he's a good doctor. Why? Because the fever will be gone right away. No, but why is this notion there in the first place? At least when I grew up, it was like that. Even it is now because there is this tendency that, okay, I need some medications to cure my body. That's not true. Your body is so smart. It'll be able to take care of itself. I always say that if you have a fever, if you take antibiotics, it will go away in three days. Okay. If you don't take antibiotics, it'll go away in 72 hours. How do you raise a healthy kid in the modern day? Other than the obvious ones, which is, okay, I'll pitch you some ideas. You tell me where I'm going right and wrong. Lots of water. Keep the kid hydrated. That's the base.
49:44 I personally would love to feed my kid a lot of raw veggies and fruits from a young age. Again, I don't know too much about raising an infant. Like I don't know why they give infants Cerelac. I'm sure there's logic behind that. You know, baby food, all that. But the moment the kid can absorb vegetables. I'm going to shower that kid with like vegetables and fruit. I'm going to make sure my kids get enough exercise and proper sleep. That means I'll take away their screens a few hours before bedtime and spend time playing with them. But ensure they sleep really well. These are my basics. Ideally, I would not like to raise children in a big Indian city. But I have the luxury of saying that because my career is such that I can work out of anywhere.
50:31 That's not a luxury everyone has. These are my top four priorities. Lots of raw food and water, lots of sleep, lots of exercise and trying to raise a kid somewhere with more nature and less air pollution, less water pollution. The fifth point is all this four needs to be done by the parent. What? The fifth point, all this four that you said needs to be done by the parent. Because your gut bacteria will... No, that's the first thing. That's where kids emulate the parent. That is the key. As we discussed earlier, Indian parents are very emotional they pour love to their kids children. They prioritize their children's lives over their own. They'll do anything for the kids to grow better, right?
51:18 To live better. But what they are failing to understand is that they need to take care of their health first. And no matter what habits they have, if parents follow the four things you mentioned, they don't have to force the kids to do it, they will do it themselves. That is what is missing. That is what is missing. I saw, I mean, while coming to this podcast, in the hotel buffet, there was a family of four. Husband, wife, two little kids. All four of them are on the phone. Okay. And then I was looking at the food items, what they are saying. A man was having breakfast, and the child was eating cereal. They had Froot Loops, croissants, and muffins. I just peeked at it. There was no fruits, vegetables, no fiber, nothing.
52:04 Okay. Then I looked at the dad's plate. Exact same thing. Exact same thing. Muffin, croissant, cereals, and he poured honey on the top of it. That's the only difference. That's the only difference. Basically, kids follow exactly what you do. Can I add a sixth point here? Because this is something I follow while I'm on vacation as well. As far as possible, I try not eating anything that's come out of a plastic packet. And I've seen it's made a huge difference to my bloating. But I'm dead sure it's making a difference to my gut. And this has been the case for a very long time. If it's chips, if it's two minute noodles, if it's sodas, like, you know, cold drinks, whatever, just avoid it.
52:51 It doesn't need to be at home. Marketing tells you that it needs to be at home and you need to keep it for parties. But you know what, you can also serve orange juice at parties. A little extra effort. But when these things are in your house, it will affect your dietary choices. If it's just there. I'm a pretty clean eater, I care about my lifestyle. But if it's a packet of chips at home, or a packet of popcorn at home, I feel like eating it. It's just how the mine is wired. The concrete jungle is also built that. You just need to not keep these demons at home. Not fall for marketing traps. It will be a big difference. And you know, people say that no, but I feel like eating snacks and all. That's okay. Listen to your hunger. But don't keep the wrong snacks at home. Absolutely. Oh, I always tell my patients is that when you tear a piece of a package,
53:37 you're tearing a piece of your gut. And it sounds very exaggerated, but it's true. The thousand hundred trillion fire cracker has to be so close to get the connections right. And each and every time you tear a package, you're creating gaps. And through the gaps, the chemicals goes inside. Let's take table sugar as the base. I also want to talk about jaggery and sugar alternatives. And you know what, I'll also put fruits in that category, because I think people overdo it with fruits. One serving of it, it's fine, but not all the time. It's not a snack replacement, etc. Vegetables, I won't say the same. So please correct me if I'm wrong. But let's start at these common aspects.
54:23 You know, I eat minimal table sugar, oriented items, oriented items? in terms of anything that has anything that's sweet, as far as possible, I avoid it. It's just how... good so you stay away from sweet? as far as possible. That doesn't mean I don't eat sweet food. Okay. Like, you know, once in a while, say, etc. Some, I do eat fruit once a day. And I, I like getting sugar from that. And I eat it as my first meal. Am I doing something wrong, right? Overall, please correct me. I want to talk about the concept of sweetness because it's a common issue people face when trying to lose weight or get fit due to their love for sweet foods. So let's just address sugar,
55:08 talk about it from the gut perspective, what actually happens. So let's go back to the, like, I'll take you through what happens when you eat a ladoo. Sure, so when you eat something, it goes down your oral cavity, oesophagus, stomatch and we talked about the stomach acids secretion, and then into the small intestine where things start to happen. Okay. What happens is, Your small intestine really likes simple sugars. So when you eat ladoo which is white sugar and soda, it's all like sweet and sugar. and then it gets easily absorbed, and then it moves into your colon. Then goes into the colon, there is no food for the bacteria In the colon. Why? because all the simple glucose has been absorbed in the small intestine.
55:58 Then it starts eating the lining of the intestine. because that debris the awakened state of colon that something has entered. Then the bacteria gets released, when it does not find anything to eat, it starts eating the walls, even if something has entered you need to feed the correct thing to the bacteria, if not, it's hungry like what we are when we are hungry we look for food doesn't matter the food is available they will create their own food okay so that is the starting process of all this right so then why i keep saying that it eats up that lining This is a very important point because when the connection gets widens on the trillion fire cracker, When the connection gets widened there is a delay in the brain-gut connection.
56:45 So, when the signal is sent to the gut, it acts slower. Then the harmful bacteria take over and start dictating their needs It secerets chemicals what it wants. It secrets dopamine which can be easily transferred through that gap, It secrets dopamine because it want's dopamine. because after the eating this simple sugar uh it's good it's good and then creates dopamine and then that dopamine gets transferred into your blood it goes into your brain it creates this craving so you the bad bacteria wants you to eat more of ladoo you know when we were kids, there were cartoons with an angel and a devil on either side. It's similar to good and bad bacteria, where the bad bacteria acts like the devil and urges you to eat sugary, popcorn, brownie, eat it
57:33 "you only live once". Sorry for the language. You're such a sweet person sir but if I'm imitating a devil I become a devil so pardon my language but coming back to ladoo [laughter] this is your inner family man coming out this is not a family show talking about my love life oh it's good it's good we'll talk about sexual health also I'm sure there is some connection of sexual health and bacteria we should talk after 10 p.m or what? [laughter] let's come back to sugar sir sugar so anyway so for sugar there are two kinds of sugars simple sugar and complex sugar so simple sugar is the one that we talked about but when you eat complex sugar what happens is this sugar is being covered by a shield
58:20 what are food items that have? for example let's say you know whole grains okay brown rice, brown rice, whole wheat okay Nachni, Ragi. so it has a complex carbs and this complex carbs is being covered by the shield so it goes into small intestine that small intestinal bacteria will not be able to digest at all because it has the genes to create an enzyme to degrade that shield And we don't have the necessary genes, that is why we rely on those bacteria. So, when we conse complex carbohydrates like ragi, brown rice, or whole wheat, a portion of it is absorbed by the stomach and then it moves to the large intestine. What occurs in the large intestine? in the large intestine uh why it is going into the large intestines we do not have the genes to create the enzyme
59:07 to degrade that shield into which the complex carb is inside you understood that Every complex carbohydrate has a coating. Okay, let me give you an analogy. if you eat a whole grain bread you need to degrade that, so we don't have the enzyme to degrade that, so it goes inside the colon, and the good bactera have the enzyme to degrade. Okay, so the main idea here is that we should increase the nber of good bacteria in our large intestine. This can be achieved by maintaining a healthy lifestyle and eating clean. In other words, we need to provide them with proper nourishment And you need them it is not that you don't need them at all and only then you'll be able to get all these digested
59:54 so when they digest it they eat their food and they also queue the galleries back to us okay so effectively you're saying that if you begin eating healthy it might be difficult for your gut and your mind initially to adopt a healthy lifestyle but as you move forward it becomes easier very easier both in terms of cravings. - yes because even your cravings are coming out of an unhealthy gut correct cravings I can guarantee you that if you start eating healthy and increasing the good gut bacteria, your cravings will decrease by 10%, 20%, or even 30% on average within six months. Cravings will be gone. But the initial will power that you are saying, people think that it is their problem
1:00:40 they think that oh you know i am craving for it people always come and tell me that hey dr pal I'm not able to lose weight because i crave for the sweet tooth of chocolate after eating, you cannot rely on willpower alone to resist cravings. Instead, you need to trick your body try consing complex carbohydrates insted of simple sugar. Or have nuts, so that you can also feed the gut bacteria, and you are getting more good bacteria, and you're creating this newer cycle where the cravings will be less so next time the cravings episode might not be that severe okay effectively this is the harsh truth about weight loss about the process of fitness in general The initial phase will be the toughest, but if you can push through the first week, the second week will be easier. The first month will be harder than the second,
1:01:26 and the first year is where you'll face your biggest challenge. But it will be life changing, if you can get past that one year, the rest of your life is easier correct take one difficult year or take 10 difficult years in your 40s 50s 60s it's one of the two correct which is why when you're young and when It's easier. Yeah, when it's easier. When your neural patterns are not that used to eating shit. Switch it up. Anything you want to add about cravings or, Especially when it's sweet cravings. You know Conor McGregor, he is a UFC fighter. He famously said that everytime he used to crave something sweet, He used to eat cinnamon to help with his cravings, so my go-to is always nuts. I also remember that our gut bacteria loves fiber and fermented foods,
1:02:12 so whenever I eat nuts, I'm also getting fiber. Again whenever I eat I always have the same thing in the back of the mind that what i am feeding my gut bacteria with so when during the cravings if i actually help my gut bacteria to decrease the cravings that's the best case scenario win-win situation for both of us in my gallbladder phase where i had the gallstone i had a big sweet tooth I wanted dessert after every meal I got so scared after that gallbladder surgery that I got scared enough to leave desserts and I saw that over the course of one year my sweet tooth died When people say they have a sweet tooth, especially if they're young, In my eyes and heart. I used to tell them it's all in their mind. But now I just say that okay,
1:02:59 although I still think it. this is artificially created this is a completely fabricated thing this is a story you're telling yourself because i'll tell you what this is a personal experience correct I think it's true for a lot of other people who've gone through something similar what eventually happens is you kind of lose your craving for sweets you don't really need dessert and after a point after you've lost that craving for dessert when you actually try eating dessert again the sugars taste that sweet taste is so sharp that all desserts taste the same
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