Meta Health: Mindfulness Meets Metabolism

S2E2: Emotional Immunity-A Major Risk for Common Diseases Feb 13, 2025

If we only pay attention to typical risk factors, we will miss what I call the "surprise diseases" that affect so many of my patients and people I know. The heart attack or plaque (detected on a heart scan) in someone who exercises and appears otherwise healthy, the breast cancer in a woman with no family history, the autoimmune disease that appears out of nowhere. How can we avert these conditions? Understanding the mechanism of Emotional Immunity (EI) is critical so you can start breaking common thought patterns. In this episode, we explore the following:

A Case Study of "Surprise Diseases"
Emotional Immunity (EI) explained and linked to disease
The most common emotional patterns that overactivate and/or suppress immunity
Key questions to identify if you're at risk
How we inherit and pass on thought patterns that disrupt immunity

S2E1: Season of Inner Change Jan 22, 2025

Meta Health is going to take a slight shift in direction with Season 2, as it incorporates more mindfulness, since it's not possible to fully optimize energy and wellbeing unless we recognize thought patterns that hold us back.

I'm calling this the Season of Inner Change, and this episode gives you an overview on my refreshed approach to sharing my insights from the clinic, from my programs, and from my personal life. Some topics include:

Why the shift?
Reconciling modern research and ancient wisdom
Format change to meet the demand of authentic human voices in an AI world
Addressing youth

S1E38: Dr.Peter Attia and I Discuss Insulin Resistance Nov 13, 2024

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)

S1E37: Alcohol's Real Impact on Body Fat and Glucose Oct 16, 2024

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

S1E36: Is Skipping Breakfast Unhealthy? Sep 12, 2024

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

S1E35: Your Body Is A Problem Jul 11, 2024

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

S1E34: Are We Taking Higher Protein Diets Too Far? Jun 04, 2024

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

S1E33: The Split Is Why You Struggle May 21, 2024

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

S1E32: New Directions Dec 28, 2023

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.

S1E31: 3 Fundamental Root Causes of Insulin Resistance Dec 06, 2023

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

S1E30: Protein, Fasting, Ketosis, and Insulin Resistance Aug 10, 2023

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

S1E29: Acetyl CoA, Citrate, and the Metabolic Merry-Go-Round Jul 06, 2023

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"

S1E28: Mental and Metabolic Effects of Work from Home Jun 21, 2023

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

S1E27: Targeting Visceral and Subcutaneous Fat Loss May 03, 2023

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

S1E26: The Science of GLP-1 Drugs and Natural Weight Loss Mar 28, 2023

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

S1E25: The Critical Pentose Phosphate Pathway and Erythritol Mar 14, 2023

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

S1E24: Metabyte #1 - Insulin Lock and Key Jan 24, 2023

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.

S1E23: Holistic Hypocrisy and Supplement Scams Sep 07, 2022

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

S1E22: Lipids Part 2 - Cholesterol Numbers and Heart Disease Risk Jun 21, 2022

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

S1E21: Lipids Part 1- Metabolic Trafficking using Cars and Boats May 24, 2022

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"

S1E20: Glucose Variability: An Essential Metabolic Metric Apr 12, 2022

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

S1E19: Rethinking Hemoglobin A1C and Are You Truly Prediabetic? Mar 22, 2022

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

S1E18: Multiethnic Metabolism and Heart Disease Risk Mar 03, 2022

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

S1E17: Blood Pressure, Body Fat, and Sodium Feb 15, 2022

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

S1E16: Getting Your Body to Burn Fat Jan 25, 2022

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

S1E15: Science of Muscle Growth and Optimal Protein Intake Jan 12, 2022

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

S1E14: Why Everyone Should Experience Ketosis Regardless of their Diet Dec 23, 2021

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

S1E13: Exploring Envy, The Forbidden Emotion Dec 15, 2021

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

S1E12: How Your Body Turns Food Into Energy Dec 08, 2021

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

S1E11: Molecular Basis for Why Plant and Paleo Diets Can Work Nov 24, 2021

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

S1E10: The Liver’s Key Role in Metabolism and Insulin Resistance Nov 17, 2021

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

S1E9: Fat Metabolism: How We Store, Move, and Burn Body Fat Nov 09, 2021

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

S1E8: Intro to Mitochondria and Energy Production Oct 28, 2021

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

S1E7: Have We Taken Fasting Too Far? Oct 13, 2021

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

S1E6: Molecular Root Cause for Insulin Resistance Sep 29, 2021

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.

S1E5: Insulin Lock and Key Model of Metabolism Sep 16, 2021

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.

S1E4: Rumination as a Gateway to Stress, Depression, and Anxiety Sep 08, 2021

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.

S1E3: Beta Cell Batteries, Fasting, and Ketosis Aug 20, 2021

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.

S1E2: Deep Dive Into Glut Subtypes and Exercise Aug 18, 2021

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.

S1E1: Using Mangos to Explain Insulin and Glut4 Aug 17, 2021

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.

Meta Health Trailer Aug 16, 2021

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.

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