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The Diary Of A CEO with Steven Bartlett

The Insulin & Heart Doctor: The Fastest Way To Burn Dangerous Visceral Fat. This is How Insulin Is Quietly Clotting Your Blood! - Dr Pradip Jamnadas

with Pradip Jamnadas

Published September 22, 2025
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About This Episode

Cardiologist Pradip Jamnadas explains how modern lifestyles drive heart disease through insulin resistance, visceral fat, chronic inflammation, and hidden factors like gut dysfunction, toxins, and mold. He describes how fasting, time‑restricted eating, targeted exercise, and gut repair can reduce visceral fat, lower inflammation, improve vascular health, and rebalance the autonomic nervous system. The conversation also covers LDL particle quality, the limitations and side effects of statins, practical diet guidance, vagus nerve "hacks", and his personal reflections on mortality and living in the present moment.

Topics Covered

Insulin resistance Fasting Type 2 diabetes Obesity and weight loss Inflammation and CRP Ultra-processed foods Gut microbiome Autonomic nervous system Sugar consumption Exercise and weight loss

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Quick Takeaways

  • Heart attacks are usually caused by an inflamed plaque that ruptures and triggers a blood clot, not just by progressive narrowing of arteries.
  • Chronic high insulin from frequent refined carb and sugar intake drives visceral fat, fatty liver, and early coronary artery disease long before diabetes is diagnosed.
  • Fasting (especially beyond 12 hours) preferentially burns visceral fat, lowers insulin, stimulates autophagy and stem cells, and can improve metabolic and cardiovascular health.
  • Gut dysfunction, leaky gut, toxins, and mold are major, often overlooked drivers of systemic inflammation and coronary artery disease.
  • Overdone steady-state aerobic exercise can increase inflammation, while resistance training and short high‑intensity intervals tend to be more heart-protective.
  • A protruding belly is a strong visual marker of visceral fat and likely insulin resistance, even if overall weight is not extremely high.
  • Vegetable seed oils, excess fruit, white bread and rice (especially without proper preparation), and over-browned foods can all aggravate inflammation and metabolic risk.
  • Vagus nerve dysfunction from gut issues and chronic stress contributes to palpitations, tachycardia, and poor recovery; breathing, humming, cold exposure and gut repair can help restore balance.
  • Total LDL cholesterol is less informative than the presence of small dense, oxidized LDL particles, which are strongly linked to plaque formation.
  • Depression, brain fog, and poor sleep can be manifestations of systemic inflammation rather than purely psychological problems.

Podcast Notes

Introduction and scope of heart disease

What Dr. Jamnadas focuses on in his career

He has spent decades focusing on prevention of heart disease, which he calls the number one cause of death worldwide.[2:33]
He explains that the heart is a pump made of muscle, arteries, valves, and surrounded by large and tiny vessels, all of which can develop disease.[2:40]

Components of the cardiovascular system that can fail

Muscle diseases such as cardiomyopathy reflect weakness of the heart muscle itself.[2:52]
Coronary artery disease refers to blockages in the arteries on top of the heart.[2:58]
Valves can be damaged, e.g., aortic stenosis.[3:03]
Peripheral circulation includes carotids, brain, leg vessels, and all organ blood supply.[3:08]
Microvascular disease affects tiny capillaries, the final small branches of the circulation.[3:13]
• He defines capillaries as the branch of the branch of the branch, the tiny end vessels, whose dysfunction leads to organ dysfunction.

Experience and shifting demographics of heart disease

He has been operating on and treating hearts for about 35 years.[3:40]
He estimates he has treated in excess of 30,000 hearts.[3:45]
Previously most patients were over 65; now about 50% are under 65, indicating younger people are developing heart disease.[4:07]
The youngest heart attack patient he has treated was 28 years old.[4:09]
• That 28‑year‑old arrived with a full-blown heart attack: an artery completely clogged with a blood clot, severe chest pain, sweating, and low blood pressure.

Mechanism of heart attacks and plaque formation

What is a heart attack physiologically?

He distinguishes between plaque buildup and heart attacks: a plaque is fibrous material inside the artery that narrows it, but this alone is not a heart attack.[5:01]
A heart attack happens when a plaque cracks; blood flowing past sees the crack and forms a clot to repair it, which then blocks the artery.[5:11]
Only about 20% of people with significant blockages have chest pain (angina), so many blockages are silent unless detected by tests like stress tests or coronary calcium scores.[5:44]
Inflammation is what causes plaque rupture; the resulting clot at the rupture site causes acute artery closure.[6:26]

Three pathological processes driving modern heart disease

First, excess plaque formation: inflammatory areas inside arteries reacting to something abnormal in the body.[6:56]
Second, plaque instability: systemic inflammation increases the chance a "pimple"-like plaque will crack open.[7:26]
Third, increased blood clotting tendency: modern inflammation makes blood more ready to clot.[8:09]
• He calls this combination of excess plaque, unstable plaques, and hypercoagulable blood the "perfect storm" explaining today's epidemic of heart disease.
Interventions like stents treat the clot and blockage but often ignore the root causes of plaque formation, rupture, and clot-prone blood.[8:33]

Insulin, visceral fat, and early coronary disease

Case study: the 28‑year‑old heart attack patient

He treated the young patient via angioplasty: inserting a catheter from wrist or groin, passing a wire, inflating a balloon to squash the clot, and deploying a stent to keep the artery open.[9:56]
The patient was overweight with belly-centered obesity, fatty liver, and visceral fat, but not yet diagnosed as diabetic.[10:27]
He was "pre-diabetic" with high insulin levels but normal glucose and hemoglobin A1c, so routine care labeled him non-diabetic.[10:34]
Insulin is described as very atherogenic: it causes smooth muscle proliferation in arterial walls, vasoconstriction, makes blood more clotty, and promotes inflammation.[11:02]

Discovery of hidden insulin problems in cardiac patients

He noticed many heart attack and artery-hardening patients had no diagnosed diabetes.[11:20]
Using in-office glucose tests on about 120 patients, he found at least half had glucose intolerance-post-glucose drink levels above normal, but not high enough to be labeled diabetic.[11:48]
About 10 years later he began measuring insulin levels in-office and saw that many patients had extremely high insulin despite only modest glucose elevations.[12:04]
He concludes that metabolic derangement is "all about insulin" rather than glucose alone.[12:16]

Basic explanation of glucose and insulin

Glucose (sugar) in the bloodstream is actually toxic; it glycates blood vessel walls, blood components, and hemoglobin, making enzymes and hormones work poorly and accelerating aging.[13:06]
When glucose is consumed, the pancreas releases insulin, which pushes glucose into cells-especially liver, muscle, and virtually all body cells.[14:02]
Eating every 2-3 hours with carbs, starches, or processed foods repeatedly stimulates insulin; glucose falls within 2-3 hours, but insulin can remain high for about 4 hours.[14:29]
Chronic frequent eating keeps insulin persistently elevated, leading over time to insulin resistance, where more insulin is required to achieve the same glucose-lowering effect.[15:26]
Processed foods are defined as products without fiber that are rapidly absorbed, forcing the pancreas to respond quickly with large insulin surges.[15:43]

Hyperinsulinemia, visceral fat, and their dangers

A person can have good A1c and glucose levels yet have chronically high insulin that silently damages metabolism.[16:14]
Insulin drives glucose into the liver, promoting fatty liver, and stimulates production of new fat (lipogenesis) around abdominal organs (visceral fat).[16:26]
Calories from general high-calorie diets distribute fat more diffusely, but excess glucose specifically tends to accumulate fat in the stomach as visceral fat.[16:45]
Visceral fat lies inside the abdomen around organs and cannot be pinched; it's highly inflammatory compared to subcutaneous fat on the buttocks.[17:03]
• He notes that biopsy of visceral fat shows many inflammatory molecules like interleukin‑6 and tumor necrosis factor, unlike gluteal fat.
He visually assesses patients: a protruding belly with relatively normal appearance from the back suggests hyperinsulinemia and visceral fat.[19:03]
By the time someone is formally diagnosed with diabetes, they likely had about 10 years of high insulin and already have coronary artery disease.[18:14]

Fasting physiology and its impact on visceral fat and health

Difference between fasting and simple calorie restriction

Cutting calories without fasting signals caloric deficit; metabolic rate slows and the body breaks down both fat and muscle.[20:30]
In fasting, the body accesses stored fat like withdrawing from a bank; it's a different physiology where stored energy is mobilized.[20:47]
In the first 12 hours of a fast, glycogen (stored glucose) in liver and muscles is used; after about 12 hours, the body starts pulling fat, especially visceral fat.[21:00]
He says fasting specifically targets visceral fat first, making it particularly beneficial.[21:14]

Types of fasting protocols he uses clinically

To reduce visceral fat in generally overweight patients, he often starts with a 12:12 schedule (12 hours fasting, 12 hours feeding) for 2-3 weeks.[23:58]
He then moves patients to 18:6 (18 hours of water/zero-calorie drinks, 6-hour eating window).[24:12]
For very overweight diabetic patients needing to lose ~60 pounds or reverse diabetes, he uses more aggressive protocols like a 48‑hour fast once a week or a 3‑day water fast every nine days combined with OMAD (one meal a day) on other days.[23:31]

Extreme supervised fasts and outcomes

He supervised a woman on a 72‑day fast (with black tea, black coffee, water, daily electrolytes, optional MCT oil for cravings), leading to resolution of diabetes, normalized blood pressure, and 55-60 pounds of weight loss.[24:12]
He emphasizes such long fasts should be medically supervised and are tailored to very sick, obese patients.[25:13]
Another patient fasted 183 days under supervision, dropping from 400 to 210 pounds, without the loose-skin appearance typical of calorie-restriction weight loss.[27:23]
He argues that fasting leads to different body changes, including skin retraction, compared to simple caloric restriction.[27:44]

Evolutionary rationale for fasting and feasting

He argues that human physiology is designed for alternating fasting and feasting; modern life has shifted to constant feasting, losing the fasting physiology.[28:07]
He notes after ~12 hours of fasting, ketone production from fat begins, indicating a switch from glucose to fat-based fuel.[29:23]

Ketones and their systemic effects

Ketones are energy molecules made by the liver from free fatty acids when insulin is low and glucose is scarce.[29:31]
The body generally runs either on glucose metabolism or on ketones as an alternative fuel.[29:51]
Ketones are described as a cleaner fuel that produce fewer reactive oxygen species in mitochondria and act as signaling molecules.[30:15]
Ketones stimulate brain-derived neurotrophic factor (BDNF), improving cognition, reflexes, and visual acuity, which he frames as nature making you a better hunter when food is scarce.[30:29]
He cautions against permanent ketosis; physiologically we are meant to cycle between glucose and fat metabolism.[30:56]

Fasting, stem cells, immunity, and blood vessel repair

He explains stem cells as pluripotent cells from bone marrow that can become various cell types, including muscle, retina, and skin.[32:00]
Breaking a fast triggers a surge of stem cells, some becoming immune cells, contributing to improved immunity and fewer infections in people who fast.[33:35]
He highlights endothelial progenitor cells, which repair blood vessel linings; intermittent fasting and time-restricted feeding increase these cells, improving vascular repair.[32:51]

Growth hormone, exercise timing, and muscle preservation

Fasting increases growth hormone production, which helps retain or build muscle.[34:29]
He advises exercising near the peak of the fast-for example, if breaking fast at 6 p.m., work out around 4 p.m.-to leverage high growth hormone.[35:09]
He recommends resistance training and high-intensity interval training (HIIT) in the fasted state, claiming both men and women tolerate this well.[35:38]

Autophagy, mitophagy, and cellular clean-up

Autophagy is described as the cell sensing no new parts are coming, then breaking down redundant organelles, packaging them, and exporting waste to function more efficiently.[37:19]
He stresses mitochondria undergo autophagy (mitophagy): old mitochondria are recycled, leading to more efficient ATP production and fewer reactive oxygen species.[38:10]
He associates the feeling of wellbeing after fasting with new, efficient mitochondria and improved cellular function.[38:50]

Exercise recommendations for heart health

Risks of excessive aerobic training

He observes that patients who do large volumes of aerobic activity (cycling 100 miles a day, running on treadmills for hours, frequent marathon training) often show more inflammation and more coronary artery disease.[39:58]
He contrasts this with people who do short sprints, resistance exercises, and HIIT, who tend to have less coronary disease.[39:58]

Balanced exercise prescription

He advises everyone needs some aerobic training for endurance-for example, not getting winded chasing a bus-but recommends limiting continuous aerobic sessions to about 15-20 minutes.[40:22]
He then urges patients to focus on resistance exercises, using body weight (planks, leg lifts, flow exercises) plus structured HIIT.[40:42]
HIIT should involve exercising hard for 30-45 seconds followed by complete rest for 30-45 seconds, enabling the body to clear reactive oxygen species.[41:04]
• He notes the rate-limiting step for cleaning up exercise-induced metabolic waste is production of antioxidants like glutathione and superoxide dismutase, which benefits from rest intervals.

Emotional toll of cardiology and limits of medicine

Managing death and suffering in cardiac practice

He has treated at least a quarter million patients and acknowledges the heartbreak of patients dying or having lives permanently changed, and of dealing with their families.[42:15]
He has seen people die in front of him, even while holding their hands in the hospital.[42:56]
He concludes life is finite and medicine cannot always extend it, but he focuses on improving health span and quality of life before death.[42:36]
He wants patients to live optimally and then "pass away just like that" rather than suffer prolonged decline.[43:15]

Cases where "healthy" people still develop disease

He recalls a man in his 60s with a coronary calcium score over 1,000, yet no diabetes, no high blood pressure, no smoking, no alcohol, and regular exercise.[43:37]
Investigation revealed chronic constipation and bowel movements every 3-4 days since childhood, indicating longstanding gut problems.[44:36]
He believes this patient's bad microbiome and GI problems drove inflammation and coronary artery disease.[44:54]

Gut microbiome, leaky gut, and fatty liver

Why the gut is central to cardiovascular health

He states the biggest interface with the external environment is the gut, not the skin.[45:11]
The gut contains roughly 100 trillion bacteria and perhaps 400 trillion viruses, which have a symbiotic role, producing micronutrients and maintaining intestinal lining integrity.[45:22]
If the right microbiome is absent, the body is deprived of key products like short-chain fatty acids.[45:46]

Mechanisms and causes of fatty liver

If intestinal lining is compromised (leaky gut), bacterial wall products like lipopolysaccharides enter the bloodstream, travel via the portal vein to the liver, and contribute to fatty liver.[46:11]
He lists three basic causes of fatty liver: excessive alcohol, leaky gut, and too much insulin driving conversion of glucose into fat.[46:11]
He calls fatty liver an epidemic; about 25% of the population now have it.[47:12]

Link between fatty liver, inflammation, and coronary disease

As a cardiologist, he became interested in fatty liver because it increases inflammation and coronary artery disease risk.[47:42]
When he changes diet to real food (not processed products), increases fiber, and adds supplements to correct nutritional deficits, he sees coronary calcium progression flatten.[48:06]
He uses serial coronary calcium scores to monitor progression: for example, going from 500 to 800 in two years signals poor control.[48:06]

Calcium, supplements, and bone health versus heart risk

Coronary calcium score versus calcium supplements

He clarifies coronary calcium is calcified plaque in arterial walls; ideal score is zero.[48:53]
He warns that calcium supplements have been shown to increase the risk of cardiovascular events in some studies.[49:12]
He states people should not take calcium supplements routinely; the problem is usually lack of vitamin D3 and K2, not elemental calcium deficiency.[50:04]
He stops calcium supplements in all his cardiac patients and instead prescribes vitamin D3 (to improve calcium absorption) and vitamin K2 (to prevent calcium deposition in wrong places like arteries).[50:16]

Warfarin, K2, and increased coronary calcification

Blood thinner warfarin (Coumadin) lowers vitamin K1 and K2 levels and is associated with increased coronary calcification.[50:46]
He routinely supplements K2 because modern diets lack fermented foods that provide adequate K2.[51:22]

Dietary advice for gut and heart: fiber, fermented foods, and lifestyle

Building a "perfect" gut through diet

He emphasizes lots of fiber so that good bacteria can thrive; sugar overfeeds the wrong bacteria, leading to SIBO.[52:03]
Because modern diets lack fiber, he advises patients to take inulin with FOS (a soluble fiber powder) daily in water or other liquids.[52:29]
Fermented foods like kefir provide beneficial bacteria and postbiotics such as vitamin K2 and short-chain fatty acids.[53:01]
He stresses that key keystone species must return to the gut for microbiome balance.[53:16]

Fiber deficiency and sources

He notes research showing U.S. men are roughly 50% fiber deficient and women about 40%; similar deficits exist in the UK.[53:25]
Fiber is found in non-processed foods; processing removes fiber to extend shelf life.[53:42]
He says we should eat 30-40 different vegetables per week, including spices, to provide diverse fibers that foster a wide range of bacterial species.[54:08]

Sleep, stress, omega‑3 and gut health

He underscores sleep's importance: people should get about 7 hours per night; lack of sleep alters the gut microbiome and repair processes.[54:46]
One night of bad sleep can make a person insulin resistant the next day.[1:00:58]
Frequent time zone changes impair liver function and gut microbiome.[1:01:28]
He calls lifestyle crucial and says we need plenty of omega‑3 in the diet.[1:01:26]

Toxins, mold, and hidden drivers of inflammation

Definition and sources of toxins

He defines a toxin as a molecule that should not be in your body and to which you should not have been exposed.[56:52]
Examples include pesticides, herbicides, plastics, "forever chemicals" like PFAS, BPA, mold, and heavy metals.[57:22]
Many of these are endocrine disruptors (e.g., estrogen receptor disruptors) and provoke inflammation.[57:18]

Role of gut and liver in detoxification

Healthy gut bacteria sequester and excrete many toxins via stools; when the gut is dysfunctional, toxicity risk increases.[58:17]
The liver is a central detox organ, but modern exposure levels can overwhelm it.[58:18]
He uses blood, urine, and stool tests to assess patients' ability to detoxify and to measure levels of things like heavy metals, pesticides, herbicides, and mold.[58:33]

Mold exposure and cardiovascular impact

He cites data that almost 70% of homes have some mold toxicity from previous water damage or other exposure; mold is ubiquitous and can repeatedly re‑inoculate people.[59:19]
Mold stimulates the innate immune system, causing low-grade systemic inflammation.[59:32]
When he treats mold toxicity, patients feel better and coronary disease progression slows.[59:46]
He notes mold can colonize the gut or sinuses; even if you leave a moldy environment, internal colonies can continually re‑inoculate you.[1:02:00]
He sees mold as more prevalent and impactful than previously recognized, with clear inflammatory signatures in blood tests.[1:02:48]

Food choices, "healthy" misconceptions, and cooking methods

What to eat to "end up on his table" (worst diet patterns)

To damage heart health, he says one should eat nutrient-deficient processed foods daily: refined wheat products, biscuits, cookies, cakes, lots of bread, fast foods, ready-made boxed foods.[1:05:01]
He includes many high-protein bars and packaged products with artificial colorings, sweeteners, diet drinks, and sugary drinks.[1:05:36]
Orange juice is singled out for causing a profound spike in glucose and insulin, leading to hunger three to four hours later.[1:05:52]
He stresses that such diets lack fiber, compounding metabolic harm.[1:06:02]

Bread, rice, and arsenic concerns

Most bread is problematic, but he considers some sourdough acceptable because fermentation reduces lectins; still, it should be eaten in small amounts and seen as a survival food, not a staple.[1:06:50]
White bread is particularly bad: essentially pure calories, similar to eating many teaspoons of sugar in one slice.[1:06:59]
White rice is a staple in many cultures, but modern rice often contains arsenic and heavy metals from contaminated soils and paddy fields.[1:08:54]
• He advises soaking rice overnight and discarding the water, then cooking with abundant water and discarding that water, cooling rice in the fridge, and reheating the next day to create resistant starch.
• Resistant starch resists digestion until reaching the colon, where bacteria consume it; this markedly reduces rice's insulin and weight-gain impact.
He describes arsenic as a heavy-metal poison used in crimes and says chronic exposure can slowly kill.[1:09:27]

Advanced glycation end products (AGEs) from cooking

Over-browning or blackening foods (e.g., fish) and frying at high temperatures create advanced glycation end products.[1:09:47]
AGEs are glucose, protein, and fat molecules combined by high heat in ways nature cannot do alone; consuming them markedly increases inflammation.[1:09:37]
The body has receptors (RAGEs) to clear AGEs, but can be overwhelmed, resulting in chronic inflammation.[1:11:27]

Other surprising problematic foods and oils

He warns against excess fruit consumption, especially out of season, due to high fructose leading to fatty liver, diabetes, and coronary disease.[1:10:55]
He recounts a patient who ate only fruit for all meals and had both mental problems and cardiovascular disease, which improved markedly after fruit was stopped.[1:12:47]
Vegetable seed oils are labeled a "no-no": they are high in omega‑6 and distort the omega‑6 to omega‑3 ratio, promoting inflammation.[1:14:22]
He tells patients to get rid of vegetable seed oil bottles at home and instead use extra-virgin olive oil for salads and small amounts of butter, ghee, or coconut oil for higher-heat cooking.[1:14:30]

Visible and symptomatic clues of cardiovascular and inflammatory health

Simple self-assessment cues

He suggests people first look at weight and BMI but notes BMI is crude and must be interpreted with body composition in mind.[1:13:02]
A key visual sign is a protruding belly (visceral fat) rather than generalized obesity; if you have a belly, he says you have a problem.[1:13:56]
He performs visceral fat analysis in-office for more precise assessment.[1:13:37]

Joint pain, autoimmune issues, and systemic inflammation

He views most joint pains not as mere degenerative changes but as driven by inflammation.[1:15:02]
When he changes diet, fixes gut issues, addresses inflammation, introduces fasting, exercise, stress management, and sleep, patients' joint pains and autoimmune diseases like rheumatoid arthritis and psoriasis often improve.[1:14:50]

Oral and sinus microbiome, bad breath, and heart disease

Oral microbiome and cardiovascular links

He confirms the microbiome extends from nose and mouth to anus, and its patterns can predict cardiovascular disease risk.[1:16:27]
Poor dental hygiene, bad teeth, and harmful mouth bacteria are unequivocally linked to valvular disease (e.g., aortic stenosis) and coronary calcification.[1:16:21]

Chronic sinusitis and fungal infections

Chronic sinusitis (persistent infections with blocked nose, headaches) is another inflammatory condition associated with premature coronary artery disease, especially when fungal.[1:18:05]
He again links fungal sinusitis to mold and low-grade systemic inflammation.[1:19:34]

Caffeine, palpitations, and autonomic balance

Caffeine's effects and safe range

He notes caffeine is structurally similar to adrenaline; too much keeps you in a sympathetic (fight/flight) state without sufficient parasympathetic offset.[1:17:07]
He considers one or two coffees a day fine but calls six cups toxic, causing diuresis, intravascular volume depletion, and further sympathetic activation.[1:17:51]
He emphasizes coffee's benefits are due to soluble fiber and polyphenols feeding gut bacteria, not caffeine itself.[1:19:00]

Palpitations and when to worry

In people with structural heart disease (blocked arteries, cardiomyopathy, valvular disease), palpitations and arrhythmias are potentially life-threatening and require prompt evaluation.[1:20:01]
In otherwise healthy young people, palpitations are often due to imbalance between sympathetic and parasympathetic nervous systems-too much stress or too little vagal tone.[1:20:25]
He sees many young women with postural orthostatic tachycardia (rapid heart rate when standing) whose symptoms improve when gut and vagus nerve function are corrected.[1:21:03]

Vagus nerve, enteric nervous system, and practical "hacks"

Role and distribution of the vagus nerve

He calls the vagus nerve the largest nerve in the body, carrying messages from brain to body and back.[1:24:36]
Its largest distribution is in the gut, highlighting how critical gut status is to the brain.[1:24:12]
The vagus also innervates the heart, lungs, face, and other regions, mediating relaxation, repair, and recovery (parasympathetic).[1:24:18]
Normal physiology alternates sympathetic (fight/flight) responses with parasympathetic (rest/relax/repair); modern life keeps people in prolonged sympathetic activation.[1:24:36]

Vagus nerve, gut ischemia, and over-exercise

He explains that extreme exercise (like a four-hour intense cycling session) diverts blood from gut to muscles, causing relative gut ischemia and damaging enteric neurons and the vagus nerve endings.[1:24:59]
After such episodes, patients can experience palpitations and arrhythmias for weeks due to vagal dysfunction and sympathetic dominance.[1:25:29]

Assessing vagal tone and heart rate variability

He cites heart rate variability (HRV) as a marker: with each breath in and out, the heart rate should vary slightly; low HRV suggests poor vagal function.[1:26:41]
When he fixes gut issues, patients' HRV improves, indicating better vagus nerve function.[1:27:47]

Nutritional and behavioral support for the vagus nerve

He says about 50% of the population are low in omega‑3; DHA and omega‑3 are needed for optimal vagus nerve function.[1:27:47]
Gut repair itself helps restore vagal function; he considers this foundational.[1:27:31]
He suggests simple breathing exercises: inhale for a count of 4, exhale for a count of 8, done about 10 minutes a day to stimulate parasympathetic activity.[1:29:07]

Physical vagus nerve "hacks"

Eye movements (looking in different directions) and gentle eye massage with cold water can stimulate the vagus via ocular pathways.[1:28:17]
Applying ice packs to the neck, especially the front where the vagus travels near the carotid sheath, can stimulate vagal activity.[1:29:47]
Humming, singing, and laughing for around 10 minutes vibrate structures innervated by the vagus and stimulate it.[1:29:47]
The Valsalva maneuver-inhaling, then exhaling against a closed airway while straining-compresses thoracic and abdominal cavities and also activates the vagus.[1:30:07]
He sometimes uses a neck-worn device that delivers pulses to the vagus; patients report feeling relaxed nearly immediately.[1:30:01]
Healthy vagal tone lowers heart rate and blood pressure, reduces blood stickiness and clot risk, and improves inflammatory markers like CRP, IL‑6, TNF, and small dense LDL.[1:31:08]

Cholesterol, LDL particles, statins, and blood pressure

LDL quality versus quantity

LDL and HDL are lipoproteins carrying cholesterol; cholesterol itself is normal and necessary, made by all cells and especially the liver.[1:32:26]
Problems arise when LDL becomes small, dense, and damaged; these particles are more easily oxidized and provoke inflammatory responses.[1:33:35]
Oxidized small dense LDL particles damage the glycocalyx lining of coronary arteries and activate the endothelium, initiating atherosclerosis.[1:34:14]
He uses LDL sub-fractionation testing to distinguish large, fluffy LDL (less harmful) from small dense LDL (high risk).[1:35:39]
He identifies five main drivers of small dense LDL: sugar, omega‑6 excess, advanced glycation end products, toxins, and lipopolysaccharides from leaky gut.[1:39:16]
Macrophages engulf small dense LDL and become foam cells, which embed in the endothelium and form plaques.[1:36:11]
He notes some data suggest people with the highest LDL overall can live into their 90s; he argues total LDL alone is not the real issue.[1:39:23]

Dietary cholesterol, eggs, and statins

He has no concerns about egg consumption; he does not see eggs as a problem for cholesterol.[1:36:56]
Statins are generally effective at lowering LDL levels, but 20-30% of patients experience side effects like muscle loss (sarcopenia), aches, new-onset diabetes, mitochondrial dysfunction, and cognitive issues.[1:38:18]
He has seen patients' memory and thinking improve after discontinuing statins when side effects appear.[1:38:14]
He questions whether statin-induced LDL lowering always translates into fewer cardiovascular events, distinguishing biochemical targets from clinical outcomes.[1:39:03]

Insulin, hypertension, and sleep apnea

Chronic high insulin impairs vasodilation of small vessels and capillaries, leading to high blood pressure.[1:40:06]
When he reduces insulin via fasting and diet changes in diabetic patients, many see their blood pressure normalize.[1:39:57]
He asserts there is no such thing as "essential hypertension" without cause; common underlying causes include sleep apnea and hyperinsulinemia.[1:40:13]

Breakfast, fasting windows, and his personal diet and supplements

Breakfast recommendations and time-restricted eating

For those who insist on breakfast, he suggests eggs, or for vegetarians, kefir with a few berries plus inulin powder.[1:40:57]
He would prefer most adults skip breakfast and eat lunch and dinner only, enabling an 18:6 fasting window.[1:42:48]
If someone must eat breakfast, he advises breakfast and lunch with no dinner, still arranging 18 fasting hours.[1:42:48]
He personally does OMAD (one meal a day) at 6 p.m. three to four times per week and says he has more energy on those days.[1:43:23]

His own diet

He eats meat, fish, chicken, and turkey in small amounts, sourcing them as grass-fed and grass-finished and organic.[1:44:16]
He explains "grass-fed" labels can be misleading and insists on grass-finished for better omega‑3, K2, nutrition, and fewer toxins.[1:44:37]
He also eats vegetables and Indian-style foods like lentils and curries; he loves chapatis and naan but limits them due to high carb content.[1:45:26]

His supplement regimen

He takes vitamin D3, vitamin K2, omega‑3 fish oil (two capsules daily), 1 gram of vitamin C, inulin, kefir, magnesium, and nattokinase (~8,000 units/day).[1:46:09]
He uses nattokinase to reduce fibrinogen and clotting tendency without causing bleeding.[1:46:27]
He also takes a spore-based probiotic (Megaspore) containing Bacillus species; spores survive stomach acid and germinate in the intestines.[1:48:09]

Screening tests, inflammation markers, and depression as inflammation

Key tests he recommends for adults

He says adults over 30 who are concerned should get a coronary calcium score; a score of zero is good, any calcium warrants preventive cardiology work.[1:48:36]
He recommends an inflammation-focused blood panel such as the Cleveland Heart Lab, which includes LDL and HDL particle sizes (small dense vs. large), oxidized LDL, CRP, IL‑6, TNF, hemoglobin A1c, and glucose.[1:48:23]
He stresses people often cannot feel inflammation; instead they notice brain fog, suboptimal performance, depression, or memory decline.[1:52:28]

Depression reframed as inflammation

He tells patients depression is often a symptom of brain inflammation rather than purely a psychological or situational problem.[1:52:19]
He has seen depression improve significantly when patients follow his anti-inflammatory diet and lifestyle program.[1:52:19]

Personal story: his father, mortality, and living in the present

Most difficult day and lessons learned

He cites his father's death as the most difficult day of his life; his father died in his sleep after refusing hospital care when acutely ill.[1:53:11]
Despite being told after bypass surgery that he had only a few years to live, his father adopted lifestyle changes (weight loss from 185 to 135 pounds, diet changes, stopping alcohol) and lived another 30 years, traveling and enjoying life.[1:53:00]
He believes his father ultimately died from being overwhelmed by a gut-related toxin following severe diarrhea.[1:54:18]
He struggled with second-guessing whether he could have done more, but learned to accept limitations as a doctor and as a son.[1:54:49]
The experience reinforced his motivation to educate people and help them change simple things that profoundly alter life expectancy and quality.[1:54:49]

Practice of present-moment awareness

He says medicine taught him to live in the present moment instead of dwelling on past cases or worrying about future ones.[1:55:20]
When with a patient or performing surgery, he aims to be fully present, treating that interaction as all that matters at that time.[1:56:00]
He urges everyone to cultivate present-moment awareness, arguing that life is only expressed in the current moment, not in past regrets or future anxieties.[1:56:40]

Lessons Learned

Actionable insights and wisdom you can apply to your business, career, and personal life.

1

Chronic high insulin from frequent refined carbohydrate and sugar intake quietly drives visceral fat, fatty liver, and early heart disease long before blood sugar tests label someone diabetic.

Reflection Questions:

  • • How often during a typical day do you consume foods or drinks that spike your blood sugar and therefore your insulin levels?
  • • In what ways could you reduce the frequency of your meals or snacks to give your insulin time to fall between feedings?
  • • What specific refined carbohydrate or sugary item could you eliminate this week to begin lowering your baseline insulin levels?
2

Fasting and time-restricted eating tap into a different physiology than calorie restriction, preferentially burning visceral fat, improving cellular repair, and enhancing vascular health when done appropriately.

Reflection Questions:

  • • What length of overnight fasting window (e.g., 12, 14, or 16 hours) would be realistic for you to experiment with over the next month?
  • • How might scheduling your workouts toward the end of your fasting window change your energy, body composition, or consistency?
  • • Which social or work routines would you need to adjust to trial an 18:6 or similar time-restricted eating pattern safely?
3

Systemic inflammation often originates in hidden sources like gut dysfunction, toxins, mold exposure, and oral infections, and can manifest as joint pain, fatigue, depression, or "normal" aging rather than obvious gut symptoms.

Reflection Questions:

  • • Where in your life are you experiencing persistent symptoms (joint aches, brain fog, low mood, skin issues) that you've been treating as isolated problems rather than signs of systemic inflammation?
  • • How could you start assessing your environment-home, water damage, air quality, processed foods-for potential hidden inflammatory triggers?
  • • What one step could you take this month to improve your gut health, such as increasing fiber, adding fermented foods, or reducing ultra-processed products?
4

Quality of cholesterol particles and vascular health are driven more by lifestyle factors (sugar, omega-6 excess, cooking methods, toxins, leaky gut) than by total cholesterol alone, so targeting root causes is more strategic than chasing a single lab number.

Reflection Questions:

  • • How do your current eating and cooking habits (fried foods, browned meats, seed oils, sweets) potentially contribute to the creation of small dense LDL and vascular inflammation?
  • • In what ways might asking for more detailed lipid testing (like particle size) change the way you and your clinician think about your heart risk?
  • • What one practical change-such as switching oils, reducing deep-fried meals, or cutting sugary drinks-could you implement to improve the quality of your blood lipids?
5

Your autonomic nervous system-and especially the vagus nerve-plays a central role in heart rhythm, recovery, and emotional state; deliberate practices that strengthen vagal tone can reduce palpitations, stress responses, and inflammatory burden.

Reflection Questions:

  • • When during your day do you notice signs of sympathetic overdrive, such as racing heart, shallow breathing, or agitation?
  • • How might incorporating a simple daily practice like 10 minutes of 4-8 breathing, humming, or cold neck exposure change your stress resilience over the next few weeks?
  • • Which gut-related habits (diet, sleep, alcohol, caffeine) could you improve to support your vagus nerve and in turn your heart and mood?
6

Living in the present moment-rather than replaying the past or fearing the future-enables clearer decisions, more meaningful relationships, and a healthier response to the inevitability of loss and mortality.

Reflection Questions:

  • • In what situations do you find your mind most often pulled into regret about the past or worry about the future instead of the task or person in front of you?
  • • How could adopting a "one patient, one conversation at a time" mindset improve your focus and impact in your own work or relationships?
  • • What small daily ritual (such as a brief check-in before meetings or meals) could remind you to return your attention to the present moment?

Episode Summary - Notes by Tatum

The Insulin & Heart Doctor: The Fastest Way To Burn Dangerous Visceral Fat. This is How Insulin Is Quietly Clotting Your Blood! - Dr Pradip Jamnadas
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