About this episode
Dr Pradip Jamnadas is a cardiologist and expert in metabolic health, known for his work on insulin resistance, fasting, and cardiovascular disease prevention. In this moment, he breaks down the real driver behind modern health issues: insulin resistance. Dr Jamnadas explains exactly what habits keep insulin elevated and causes visceral fat gain, inflammation, and diseases like diabetes. He also reveals the key to reversing this metabolic dysfunction, that you can start implementing today. Listen to the full episode here: Spotify: https://g2ul0.app.link/x6ShJA3YV1b Apple: https://g2ul0.app.link/BMi7037YV1b Watch the Episodes On YouTube: https://www.youtube.com/c/%20TheDiaryOfACEO/videos Follow Pradip: https://www.youtube.com/channel/UCOtQHehGWtblMp1gZC8Kq3Q
Episode summary
I opened by saying glucose and insulin still confuse me, and asked you to spell out the basics because it clearly matters.
Sugar in the blood is corrosive; insulin moves it into cells, but grazing on carbs all day keeps insulin high, damages proteins through glycation, and slowly drives insulin resistance. That background insulin builds fatty liver and deep belly fat around organs, derailing metabolism long before a lab flags diabetes.
So frequent starchy meals spike insulin and set off that whole cascade?
Yes; insulin lingers longer than glucose, so years of repeat hits create insulin resistance and often a decade of hyperinsulinemia before sugar finally rises and artery disease is already brewing. We should check insulin early, but clinics rarely do.
When does that harm typically start—I’m thirty‑three.
Trouble often shows up around thirty, and you see it in the protruding waistline that gains fast on vacation and is hard to lose because insulin tells the body to store. Cutting calories slows metabolism, but fasting lowers insulin, burns glycogen then fat after about twelve hours, and targets inflammatory visceral and ectopic fat in the liver, pancreas, and even around the heart and arteries.
Given that, what kind of fast actually works best compared to a simple calorie deficit?
For trimming visceral fat I start with a twelve‑hour fast and a twelve‑hour eating window, then move to eighteen hours fasting with six hours to eat. For significant weight and diabetes reversal, I use protocols like one forty‑eight‑hour fast weekly or nine days of one meal a day followed by a three‑day water fast, all supervised.
Does that approach change for women, given estrogen shifts and cycle sensitivity?
Most women tolerate fasting well unless they’re trying to conceive or are pregnant, and I’ve guided severe cases through extended medical fasts. One woman on a seventy‑two‑day physician‑supervised fast saw diabetes resolve, blood pressure normalize, and major weight come off.
What exactly can someone have during a medical fast like that, and what were the before‑and‑after details?
We allow water, black coffee or tea, daily electrolytes like mineral salt, and a teaspoon of MCT oil if cravings hit; under care, she lost roughly sixty pounds and her shape tightened rather than sagged, which I also see with large losses from prolonged fasting. Fasting works differently than dieting and restores a feast‑and‑fast rhythm we’ve largely lost.
After about twelve hours without food, low insulin lets fat release, the liver turns it into ketones, and your body switches from glucose to this alternate fuel. Ketones are cleaner and spark helpful signals in the brain and body.
So ketones show up when glucose isn’t available.
Right, and they boost brain‑derived factors tied to sharper thinking and quicker reflexes, nature’s way of helping you hunt when you’re hungry. They also reduce reactive oxygen stress compared with glucose.
If ketones are so good, why not stay in ketosis all the time?
Our biology is built to cycle, not live in permanent ketosis, and fasting waves also mobilize stem cells that repair vessels and bolster immunity. I time resistance or high‑intensity sessions near the end of a fast because growth hormone peaks then and helps preserve or add muscle.
Some experts warn women can lose muscle if they train fasted due to heightened glucose sensitivity; how do you square that?
Long steady cardio while fasted can be a problem, but women do well with fasted resistance and high‑intensity intervals because you work hard, then fully rest, without draining glycogen for an hour straight. Save the treadmill marathons for fed sessions if needed.
A ketogenic diet is very low carb; do you keep people in it or cycle?
I cycle it—use ketosis to hit a weight or metabolic target, then shift to eighteen‑six time‑restricted eating and toss in an occasional thirty‑six‑hour fast. You don’t need nonstop autophagy; it’s a tool, not a home.
Explain autophagy in plain language.
When nutrients are scarce, cells clear out worn parts and refresh mitochondria, which boosts energy and lowers oxidative waste so you feel better after a fast. That cleanup also helps move toxins out.
With heart issues in my family, what exercise style best protects the heart?
In my clinic, chronic long‑distance training correlates with more inflammation and plaque, whereas a little aerobic work for endurance plus resistance and interval training does better for arteries. Short bouts with full rest let your antioxidant systems catch up, and simple body‑weight flows like planks and leg lifts work well.
That was a most‑replayed moment from an earlier episode; the full conversation is linked in the description—thanks for listening.