Friday, April 19, 2024
Mitochondrial Health

#88 – Paul Grewal, M.D.: Treating metabolic illness and techniques for long-term well being

On this episode, Paul Grewal, inside medication doctor and co-author of Genius Meals, discusses what has bought him so centered on life-style adjustments for metabolic well being which was partly introduced on by his personal expertise of dropping nearly 100 kilos at two factors in his life. Paul and Peter talk about how the outcomes from a NuSI-funded research has impacted their emotions concerning the supposed “metabolic benefit” of a low-carb eating regimen. Paul then makes the case for what he calls the “lively poisoning” of the American meals provide, defines his 5 phenotypes of weight problems manifestation, in addition to lays out his dietary and coaching method along with his sufferers (in addition to himself personally). Total, this dialogue is a treasure trove of subjects from endocrinology, insulin resistance, caloric restriction, fasting, train, causes of weight problems, LDL and coronary heart illness, and rather more. 


We talk about:

  • Paul’s well being story—two cases of main weight reduction [3:15];
  • The multiplication of adipocytes after weight reduction, and why an overweight grownup that was obese in childhood is tougher to deal with than adult-onset weight problems [7:30];
  • Low-carb diets—Is there a metabolic benefit in power expenditure? (And Peter’s tackle the NUSI research) [12:45];
  • The connection between hyperinsulinemia and hyperglycemia—which is inflicting which? [27:00];
  • Weight acquire—Which macronutrients are driving it, processed meals, and overfeeding research [31:15];
  • The lively poisoning of our meals provide with processed meals [36:15];
  • The function of fructose in metabolic illness and NAFLD [39:00];
  • The place conventional medication falls brief in the actual world and why “practical medication” is gaining steam [45:45];
  • Relationship between coronary heart illness and LDL, residual threat, LDL clearance drawback, and a affected person case research [54:00];
  • Relationship between coronary heart illness and fatty acids (SFA, PUFA, seed oils, and so on.) [1:04:30];
  • Paul’s dietary method with sufferers [1:12:30];
  • Excessive-carb/low-fat eating regimen for muscle acquire, and the “reverse eating regimen” to fight the slowdown of metabolism after caloric restriction/weight reduction [1:15:00];
  • Fasting—preferrred period, how you can protect muscle mass, and the final word instrument of drugs [1:23:30];
  • The 5 phenotypes of weight problems, and the impression of carbs, cortisol, and sleep on adiposity [1:28:30];
  • Uric acid [1:38:15];
  • Paul’s 2nd huge bodily transformation—How he did it and saved the load off [1:39:15];
  • Paul and Peter’s private struggles with meals, inside dialogue, and self-image [1:45:00];
  • Paul’s private dietary technique (and the way his train influences it) [1:52:00];
  • A low-fat eating regimen Peter is prepared to strive [2:00:40];
  • The keto eating regimen for aggressive athletes [2:05:00];
  • How Peter prescribes train to his sufferers [2:08:30];
  • Calculating glycogen depletion and RQ, creatinine-kinase system, Tabata exercises, and extra [2:10:30]; and
  • Extra.


Paul’s well being story—two cases of main weight reduction [3:15]

  • Dad was from India
  • Mom from Cyprus
  • They met in London, finally got here to America when Paul was younger
  • Each his mother and father placed on 15-20 lbs proper after shifting to the US
  • Fed Paul the “customary eating regimen” not know that “the meals provide was being actively polluted or poisoned” 
  • By the point Paul was 12
  • 95th percentile in weight
  • Had an additional 50 or 60 kilos as a 12 12 months outdated

I mainly have gone by means of the primary half of my life simply as what we might describe as a fats particular person. And that has huge results on self-perception, it has huge results on how others understand you, and there’s a peculiar American form of ethos round it being one of many few issues that we’re nonetheless allowed to be discriminating or discriminatory towards.

Paul’s first transformation

  • By the point he was in faculty he was 275 lbs
  • Went on a caloric restriction eating regimen of ~1200 energy per day
  • Did 6 miles per day on a treadmill
  • Misplaced 90 lbs
  • However as quickly because the stress from med faculty hit, he gained nearly all the load again

Paul’s second transformation

  • In med faculty, he managed to lose the load once more with a unique method
  • He’s been capable of maintain it off since then
  • (Extra to come back on how he did this later)


The multiplication of adipocytes after weight reduction, and why an overweight grownup that was obese in childhood is tougher to deal with than adult-onset weight problems [7:30]

The multiplication of adipocytes following weight reduction

  • Paul says a part of the explanation that folks discover it tough to shed pounds after they’ve already misplaced it and regained it is as a result of…

    • Adipocytes shrink throughout weight reduction
    • However once you regain the load, they don’t simply develop again to regular dimension, they really multiply 
    • After which…every a type of fats cells doesn’t cease rising till it’s reached the dimension of the unique adipocyte 
    • It’s a “rubber banding” impact and it turns into increasingly more tough to lose the load

-How vital of weight reduction is required to set off that new expression of adipocytes that as a substitute of merely regaining dimension, they multiply?

  • Largely been demonstrated in animal models, says Paul
  • In all probability has to do with the physique’s counter-regulatory mechanisms to forestall weight reduction
  • Paul’s suspicion can be that when these begin to kick in that there’s most likely some epigenetic adjustments that dictate that
  • However I don’t suppose it’s quantifiable at this level.
  • Peter’s says it appears imminently testable by taking fats biopsies of individuals throughout a interval of weight discount and weight regain
  • (Peter wonders if Rudy Leibel has examined this)

Why childhood weight problems appears tougher to deal with

-Paul observes completely different phenotypes of obese folks in his medical apply…

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Paul Grewal, M.D.

Dr. Paul Grewal is a board-certified Inner Medication doctor serving sufferers within the Higher East Aspect, New York, New York. Dr. Paul Grewal supplies quite a lot of providers to sufferers at MyMD Medical Group, together with holistic and integrative well being, preventive care, and vaccinations.

Dr. Paul Grewal earned a Bachelor of Arts in Mobile and Molecular Neuroscience from Johns Hopkins College. After graduating, he went on to check medication at Rutgers, New Jersey Medical College. He accomplished his residency at North Shore-Lengthy Island Jewish Hospital.

Dr. Paul Grewal has a eager curiosity within the holistic prevention and therapy of illness. He takes nice delight in serving to his sufferers with their particular person well being wants, from reversing illnesses like kind 2 diabetes to shedding weight or managing their hormones.  

In his spare time, Dr. Paul Grewal enjoys spending time on the one pull-up bar in Central Park. []

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