Category Archives: India

High Diabetes Rate in South Asians in the U.S. Is Not Related to Body Composition (e.g., High BMI)

Indian woman cooking chapati

“We did not identify strong evidence that accounting for body composition explains differences in the risk for type 2 diabetes. Future prospective studies of the MESA and MASALA cohorts are needed to understand how adipose tissue impacts the risk for type 2 diabetes and how to best assess this risk.”

So the high incidence of diabetes and prediabetes in South Asians in the U.S. is related to genetics or diet or activity levels?

Source: Body Composition and Diabetes Risk in South Asians: Findings From the MASALA and MESA Studies | Diabetes Care

Steve Parker, M.D.

Click pic to buy book at

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Random Notes on Indian Cuisine

Chicken Kolhapur from Chennai Chettinaad Palace

From Madhur Jaffrey’s “An Invitation to Indian Cooking,” 1973 (43 years ago)

“Curry” is just a vague, inaccurate word which the world has picked up from the British, who, in turn, got it mistakenly from us.

“Us” being Indians.

If “curry” is an oversimplified name for an ancient cuisine, then “curry powder” attempts to oversimplify (and destroy) the cuisine itself.”

“Try to buy only whole spices and grind them yourself in small quantities.”

  • in coffee grinder
  • better flavor
  • whole spice that the grindings came from lasts longer
  • store in jar with tight lid away from light

“It is the preparation and combination of whole or freshly ground spices which makes Indian foods unique.”

Ghee: two types. See p. 9

Her recipes are adapted for American kitchens and stores. They focus on Delhi and adjacent sections of Uttar Pradesh.

Meat is usually goat. Fairly tough, so it is cooked slowly or tenderized.

80% of India is Hindu, who technically do not eat beef.

Cooking chicken? Usually remove skin first.

A tandoor is a clay oven with a live coal or wood fire.

Tandoori chicken is indeed popular in India.

“Indians never use olive oil,” but she does.

Fruits and veggies in India  (1973) were/are very seasonal. Not eaten out of season.

Coriander (Chinese parsley or cilantro) and green chilies are essential.

Many Indians don’t like or eat hot (spicy) foods.

Most Indians eat a lot of greens: spinach, mustard greens, fenugreek greens, white radish greens, gram (or chick pea) greens. Spinach is popular over all of India.

Potatoes are a staple in North India.

The average Indian (1973) eats 1/2 to 2/3 pound of rice/day [cooked weight, I guess]. Her recipes use Carolilna (a long-grain uncooked rice) or basmati. (I must re-read. Is Carolilna really Carolina?)

Dals = lentils or pulses = varieties of dried beans and peas.

  • daily in most Indian homes
  • always eaten with rice or bread

Various home-made pickles are popular. By no means only made with cucumbers. Even meat can be pickled.

Chutney p. 226-7.

Her childhood family had servants.

Indian breads are called roti.

  • chapati, paratha, porris, naan
  • naan is leavened
  • typically whole wheat flour
  • cooked on a cast iron griddle or clay oven (tandoor)

In India most meals end with fruit.


From “Beyond Curry Indian Cookbook” by Denise D’Silva Sankhé, 2016. Subtitle: A culinary journey through India.

She’s a columnist at Serious Eats (Beyond Curry).

Over 50 languages in India.

“Curry, to most Indians, is only one type of dish, a gravy or sauce-based one, which can have meat or vegetable in it. “In India, there is no one “curry powder.”

Again, many regional differences in flavors and foods.

Grind your own spices. Store them dark and dry, in steel or glass airtight, in fridge maybe.

A masala is just a blend of spices; quite variable.

Nutmeg is poisonous, but use it anyway.

Dal designates more than lentils. Dals  are a staple, served at least a few times/week. Dal-chawal is a simple dish of lentils and rice, and perhaps the most comforting of foods to Indians.

“Indian food is traditionally eaten  by hand.” The right hand. The left is unclean.

“Mise en place” p. 35.

Some religions forbid alliums (e.g., onions and garlic) and root veggies. Substitute asefetida for the alliums.

Desserts and sweet treat are common, especially in religious and other festivals and celebrations.

Shop for pantry essentials and spices at specialty stores: Indian, Asian, Middle Eastern.

Buy spice in small quantities. They don’t store well for long.

Green chilis (sic): lighter-colored, longer ones are less spicy. Shorter, dark green ones are very hot. Thai and serrano chiles (sic) are fine substitutes.

When her recipes call for onion, she means red onion (can substitute white ones).



Search DietDoctor and you will find. Also


From Today’s Dietitian magazine:

August 2014 Issue

Indian Cuisine — Foods That Hold a Special Place in Plant-Based Food Traditions
By Sharon Palmer, RDN
Today’s Dietitian
Vol. 16 No. 8 P. 17

[Ed.: copy/pasted with a few paragraphs deleted. Click the link above for some recipes.]

Gita Patel, MS, RDN, CDE, LD, CLT, author of Blending Science With Spices, explains that Indian culture leans toward vegetarianism due to Hinduism, which hosts a central theme of nonviolence, including animals. “A profound respect for all life is a common Hindu belief that supports vegetarian eating styles,” adds Vandana Sheth, RDN, CDE, a spokesperson for the Academy of Nutrition and Dietetics.

However, British colonial influences and Western food trends, such as the emergence of fast-food restaurants, have brought more animal foods into India, Patel says. “With the globalization of the world and technology, some of the urban lifestyle changes have significantly affected traditional food practices in India,” Sheth adds, listing as evidence the increasing number of fast-food restaurants and premade foods replacing traditional meals in India.

Traditional Eating Patterns
“A lot of people are drawn to Indian cuisine. People like the flavors, herbs, and spices,” Patel says, noting that home cooking is vastly different from what you’re likely to sample in an Indian restaurant.

“The traditional eating pattern is very balanced,” Patel says. She describes typical meals consisting of dal (a legume dish), rice, roti (bread), vegetable, salad, fruit, and a yogurt or buttermilk drink, which may vary slightly depending on the region.

Indeed, there’s scientific consensus that a disease-protective diet is based on a variety of whole plant foods, which sums up the traditional Indian eating pattern. “The traditional Indian vegetarian diet is one that’s rich in a wide variety of grains, beans, lentils, vegetables, fruits, nuts, seeds, spices, and herbs. Research has found that vegetarians have a lower risk of heart disease and some types of cancer,” Sheth says. The National Cancer Institute reports that cancer rates are lower in India than in Western countries, and that diet characteristics such as a high intake of fruits, vegetables, spices, and tea may be responsible for protecting Indians against certain forms of cancer.2

Key Components
While the specific dishes may vary according to different regions of India, the key ingredients basically are the same and include the following:

• Vegetables: “Vegetables are grown all over the country due to the climate,” Patel says, adding that many vegetables are unique to India, such as specific types of gourds, radishes, beans, and greens. However, other dishes are based on more familiar vegetables, such as beets, Brussels sprouts, cabbage, carrots, cauliflower, celery, cucumber, corn, eggplant, green beans, various greens, okra, onions, peas, peppers, potatoes, radishes, spinach, squash, and tomatoes. In addition, fermented foods such as pickled vegetables are a regular feature in Indian cuisine.

• Grains: Rice and wheat are staples in India and used in flatbreads (eg, dosa, roti, chapati), doughs (eg, samosa, kachori), and side dishes (rice) to accompany meals.

• Legumes: Indian cuisine relies on the regular and flavorful use of legumes, such as black-eyed peas, chickpeas, lentils, and beans. In addition to dal, many legumes are sprouted or used as flour in breads.

• Fruits: Apples, apricots, bananas, figs, grapes, guavas, lychees, loquats, mangoes, oranges, papayas, passion fruit, and sweet limes are common fruits in India.

• Dairy: From milk and buttermilk to yogurt and paneer (fresh cheese), dairy products are regular features of the Indian diet. Patel reports that most Indian households receive fresh milk, which is then used for beverages and cooking. Households make their own ghee (clarified butter) from the milk fat, and leftover milk is made into fresh yogurt every day.

• Vegetable oils: Most oils used in traditional cooking are unrefined vegetable oils, such as peanut or sesame. However, Patel reports an increase in the use of refined oils, such as soybean oil, in modern cooking.

• Herbs and spices: At the heart of Indian food is a long list of culinary herbs and spices that have been used for centuries, many of which are proven to have antioxidant, anti-inflammatory, antimicrobial, and anticancer effects. Indian spices include amchur (made from mangoes), aniseed, asafetida (a pungent, onionlike flavor), bay leaf, black pepper, cardamom, chilies, cinnamon, cloves, coconut, coriander, cumin, dill, fennel, fenugreek, garam masala (a spice blend), garlic, ginger, mango powder, mint, mustard, nutmeg, onion seeds, parsley, pomegranate seeds, poppy seeds, saffron, sesame seeds, tamarind, and turmeric.

— Sharon Palmer, RDN, is a contributing editor to Today’s Dietitian and the author of The Plant-Powered Diet and Plant-Powered for Life.





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Indian LCHF Diet Has an Internet Following at dLife

Chennai Chettinaad Palace Indian restaurant in Phoenix, AZ

At my Paleo Diabetic blog, Santosh left a comment informing me that dLife has a forum dedicated to Indian LCHF (low-carb, high-fat) eating for diabetes and obesity!  (I hope that link works for you.) I don’t think Santosh would mind my reproducing the comment here:

Hi Steve,

I saw your reply on one of the Indian LCHF site ( and from their I could trace you here.

In that particular reply, you have mentioned that, “I am very interested in type 2 diabetes in folks of Indian ethnicity. I know that LCHF eating does wonders for Europeans and European-Americans in terms of weight and blood sugar management. I suspect that LCHF works equally well in Indians, and Tina and her husband’s experience supports that idea. But I’m looking for firmer evidence than anecdotal. I haven’t finished my scientific literature review yet. I spent 30 minutes on last night and came up with nothing.” which caught my eye!

We have a dedicated forum for Indian Diabetics wherein we advocate and follow LCHF diet to maintain diabetes at bay and you can get testimonies from many folks there.

It would be nice, if you can join our forum ( and share your views as well.



Just FYI, if you’re interested like I am.

Steve Parker, M.D.

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Do You Use a Pressure Cooker?

Vegetarian Fried Rice with bits of cabbage, carrot, celery, and (?) cilantro.

Definitely NOT low-carb: Vegetarian Fried Rice with bits of cabbage, carrot, celery, and (?) cilantro.

Judging from the bloggers I follow, pressure cookers started making a comeback within the last couple years. I remember my mother decades ago occasionally using one, for what, I don’t know. I’ve been thinking about a pressure cooker myself recently as I learn more about Indian cooking.

As you may know, many Indians are vegetarians. They eat lots of legumes, as do non-veg Indians, as an important source of protein. If you cook dried beans, it normally takes hours unless you get them from a can, pre-cooked. A pressure cooker reduces cooking time to 40 minutes.

Dr. Travis Saunders wrote about his pressure cooker, which was inspired by Dr. Stephan Guyenet. Travis wrote:

For those who are unfamiliar with pressure cookers, they’re a bit like slow cookers. The difference is that they seal in pressure (this is why the old fashioned ones sometimes exploded when left unattended), so they can cook food much faster than a regular stove or slow cooker. So things that would normally cook all day, can be cooked in under an hour.

Travis uses his to make yogurt and soup. It also cooks rice. 

I’m gonna get one someday.

Steve Parker, M.D.

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Does Indian Food Confuse You, Too?


Chennai Chettinaad Palace Indian restaurant in Phoenix, AZ

The first time I ate at an Indian restaurant, I was as confused as a newborn baby in a topless bar. The menu had too many unfamiliar foreign words.

Ian Anderson of Jethro Tull fame published a guide to Indian food for greenhorns. A snippet:

Let’s first consider the mild: Korma, Passanda and Muglai are the words to watch for. Liberal in their creamy mildness, these dishes, from different areas of the Indian sub-continent, will be face and bowel-savers when the chips are down.

For those who favour the dryer ,purer and not-too-hot taste of the source meat or fish, try the Tikka or Tandoori versions.

Really spicy hot stuff will be tackled head-on in the Madras or Vindaloo variations on the theme. Brave but occasionally foolish forkers, like me, will feel compelled to go for the Phal or Tindaloo, those macho show-off botty-crippling dishes which we become strangely ever-addicted to. Nothing disrupts a band sound-check like the pervasive after-effects of the Tarka Dhal (lentils and garlic).

It’s a very helpful guide to Indian restaurant menus although not necessarily for authentic Indian cuisine.

In case you didn’t get my metaphor…

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Does LCHF Eating Help Indians With Diabetes?

Surfing the net, I ran across an Indian lady named Tina who is successfully treating her T2 diabetes with LCHF eating (low-carb, high-fat). Both she and her husband lost excess weight, too. Click for her website.

In turn, she directed my attention to a YouTube channel by Dr. S. Vijayaraghavan, who is also a LCHF advocate for people with diabetes, type 2 anyway. Check out Goodbye Diabetes.

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I Lost My Virginity at an Indian Restaurant


Chennai Chettinaad Palace in Phoenix, Arizona

Chennai Chettinaad Palace in Phoenix, Arizona

Tonight I ate at my first Indian restaurant, Chennai Chettinaad Palace, at 2814 W. Bell Rd., Phoenix AZ 85053. This post isn’t a restaurant review, however. It’s a thumbnail sketch of my introduction to Indian food.


We ended up here because it was recommended to my wife by an Indian gentleman she happened to sit next to on a plane trip. The restaurant has an extensive menu of what they say is authentic North Indian, South Indian & Gujarati food, both vegetarian and non-vegetarian.

We arrived at 6:40 PM and there were few patrons present. One hour later the place was full of apparent Indians.

Two of us started out with, and enjoyed, an appetizer called Gobi Manchurian.

Gobi Manchurian: spicy cauliflower pieces lightly battered and fried.

Gobi Manchurian: spicy cauliflower pieces lightly battered and fried. Yum!

It would have been too spicy for my third dining mate, who simply ate garlic naan (bread) and vegetarian fried rice. Both were delightful, although the rice was a tad oily. The rice dish easily serves four diners. The naan is addictive; split an order with your mate or you’ll eat too much.

Garlic Naan, a type of flat bread

Garlic Naan, a type of flat bread

Vegetarian Fried Rice with bits of cabbage, carrot, celery, and (?) cilantro.

Vegetarian Fried Rice with bits of cabbage, carrot, celery, green onion, and (?) cilantro.

My main entree was Chicken Kolhapuri. I was forewarned it would by spicy hot. I enjoyed it. My wife wouldn’t dare taste it. I’d get it again. I dipped my naan in the copious chicken sauce (a curry?).

Chicken Kolhapuri. Sauce includes ginger, garlic, sesame, and red chilly (sic) paste.

Chicken Kolhapuri. Sauce includes ginger, garlic, sesame, and red chilly (sic) paste.

Brian ordered Chicken Tikka Masala but didn’t like it. I don’t think it was bad; it just didn’t suit his taste, the way some folks don’t like asparagus.

Chicken Tikka Masala with a "traditional North Indian sauce" of roma tomatoes, fenugreek, and garam masala.

Chicken Tikka Masala with a “traditional North Indian sauce” of roma tomatoes, fenugreek, and garam masala.

We finished with an ice-cream style dish. If you want ice cream, stop at Baskin-Robbins on your way home.

Mango and Pistachio Kulfi

Mango and Pistachio Kulfi

Service was good. Our waitress was patient with us Indian food virgins. If you’re not familiar with Indian food, you won’t make sense of much of the menu. The restaurant was too cold for my wife, but fortunately she had brought a jacket. The bill for three of us was $63.42 (USD). We brought home two platefuls of leftovers.

I’ll visit again. I’m interested in vegetarian dishes, lamb, goat, and seafood. The secret to Indian food may be in the spices.

The rice, naan, and desert have too many carbohydrates for many diabetics. I’m sure there are low-carb alternatives, even if you have to make them yourself.

Steve Parker, M.D.

PS: The restaurant offered a 10% discount for customers paying with cash instead of credit. I always thought the credit card companies cut of credit card payments was only 3-4%.




Filed under India, Uncategorized

Are You Visiting This Site From India?

Gadi Sagar temple on Gadisar lake at sunset, Jaisalmer, India

Gadi Sagar temple on Gadisar Lake, Jaisalmer, Rajasthan, India

I’ve been surprised by how many blog visitors I get from India—often more than I see from U.K, Canada, or Australia.

If you’re Indian, is there anything in particular you’d like to see me address here? Leave a comment below or email me at steveparkermd AT Thank you.

Steve Parker, M.D.

PS: Please let me know if you are aware of a good source of low-carb Indian recipes in English. I have a growing interest in curries.


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Book Review: The South Asian Health Solution

Indian woman cooking chapati

Indian woman cooking chapati

Here’s my review of The South Asian Health Solution: A culturally tailored guide to lose fat, increase energy, avoid disease by Ronesh Sinha, published in 2014.

♦   ♦   ♦

Dr. Sinha practices internal medicine in northern California (Silicon Valley) and has a large dose of South Asians in his clinic. “South Asia” usually encompasses India, Pakistan, Nepal, Bangladesh, Bhutan, Sri Lanka and Maldives. It is home to one fifth of the world’s population. This book pertains mostly to Indians, which is Dr. Sinha’s ethnicity. I live in the Pheonix, AZ, area and we have a fair number of Indian engineers and physicians.


Because Dr. Sinha says they have unique genetic and cultural issues that predispose them to type 2 diabetes, abdominal obesity, coronary artery disease, high blood pressure, and adverse cholesterol numbers. For example, compared to natives who stay in their home countries, South Asian immigrants to the West have 3–4 times higher prevalence of diabetes, he says. Dr Sinha has a program that he’s convinced will prevent or forestall these medical problems in South Asians.

Dr. Sinha says South Asians eat too many carbohydrates and are too sedentary. Especially those who have moved to the West (e.g., US, UK, Europe, Canada). He notes that the core of the typical South Asian diet is flat breads, lentils, rice, fried crispy snacks (with heart-poisoning trans fats), culminating in 150–200 daily grams of carbohydrate more than he sees in other ethnics in California. Western fast foods, sodas, and sweets compound the problem.

He says “most South Asians are skinny-fat,” meaning skinny legs and arms but with a fat belly from visceral fat. This is also called sarcopenic obesity. The usual “healthy” body mass index (BMI) numbers don’t apply to Asians. The World Health Organisation classifies Asians as underweight if BMI is 18.4 or less, healthy at BMI of 18.5 to 13, overweight at BMI 23.1 to 25, and obese if BMi is over 25. These numbers are lower than those used for non-Asian populations.

Another issue in his South Asian patient population is vitamin D deficiency related to their dark skin (hence, less vitamin D production) and too much time indoors. He says vitamin D deficiency promotes inflammation and insulin resistance. More on this below.

Some South Asians have a K121Q gene mutation that causes insulin resistance, which in turn can cause disease. And whether it’s genetic or not (but I think it is), he says South Asians tend to have higher Lp(a) [aka lipoprotein(a)], which causes early and aggressive coronary artery disease. They also tend to have small dense LDL, leading to a lower-than-expected total cholesterol level which may be deceptively low.

Sinha notes a strong vegetarian preference in Indians but spends almost no time discussing it. From the book, I can’t tell if Indian vegetarians are lacto-ovo-vegetarians, pescetarians, or vegans. The author is not a vegetarian.

Gadi Sagar temple on Gadisar Lake, Jaisalmer, Rajasthan, India

Gadi Sagar temple on Gadisar Lake, Jaisalmer, Rajasthan, India



So, South Asians, at least in the West, have a high-carb diet, are too sedentary, and have genetic tendencies to heart disease and diabetes. How do these factors cause disease? It’s all tied together with insulin resistance. Insulin is the main hormone that keeps our blood sugar from rising too high after we digest a meal. Insulin drives blood sugar into our body cells to be used as energy or stored as fat or glycogen. If our tissues have insulin resistance, blood sugar levels rise. As a compensatory effort, our pancreas excretes more insulin in to the blood stream than would normally be the case. Whether or not that eventually lowers blood sugar levels, the higher insulin levels themselves can cause toxicity. For example, higher insulin levels raise blood pressure, which damages the cells lining the insides of our arteries, leading to chronic inflammation and atherosclerosis (hardening of the arteries). Some of the arterial damage is mediated through small dense LDL cholesterols (aka type B LDL), which is promoted by high insulin levels (hyperinsulinemia). Insulin resistance also results in a defective and overactive immune system, which further promotes chronic inflammation. This inflammation is “…the root cause of almost every imaginable chronic disease…from heart attacks and strokes to Alzheimers Disease.”

Anyway, this is Dr. Sinha’s hypothesis, and there is some scientific evidence to support it. Sinha says that the concept of insulin resistance “weaves together virtually every chronic ailment currently afflicting South Asians.” That may be a bit hyperbolic: He carves out no exceptions for arthritis, asthma, eczema, migraines, glaucoma, macular degeneration, hearing loss, erectile dysfunction, hepatitis C, prostate enlargement, toenail fungus, or male-pattern baldness.

Dr. Sinha’s Grand Unification Theory of Disease Causation has some support among physicians and scientists, but is by no means universally accepted among them. As for myself, I think he’s over-simplifying (for his readership’s sake?) and getting a bit ahead of the science.

Most clinicians aren’t testing directly for insulin resistance. What are the indirect clues? Belly fat, low HDL cholesterol, high trigylcerides, high blood pressure, prediabetes, and type 2 diabetes. These are components of the metabolic syndrome. Not everybody with one or more of these factors has insulin resistance but many do.


If Sinha is correct, the South Asian Health Solution is a “low-insulin lifestyle” achieved through carbohydrate-reduced eating, exercise, and avoidance or resolution of belly fat. These help improve all components of the aforementioned metabolic syndrome. The backbone of the plan is carbohydrate restriction. For low-carb eating, avoid wheat bread and Indian flat breads (e.g., chapatis, naans, parathas, puris, phulkas), aloo (primarily potatoes and starchy vegetables), rice and other grains, beans, and sugar. Keep track of your net carbohydrates (he likes, which includes South Asian foods).

If you need to burn off body fat, limit carbs to 50–100 grams/day (digestible or net carbs, I assume). Aim for 100–150 grams/day to maintain health and weight loss.

You might be able to add “safe starches” later: white rice, potatoes. To replace your Indian flat breads, learn how to make them with substitutes for wheat flour: coconut flour or almond flour (no skins) or almond meal (skin included). Recipe on page 347. Rice alternatives are cauliflower “rice,” shredded cabbage, broccoli slaw, chopped broccoli, and chopped carrots.

He likes ghee, extra virgin olive oil, coconut oil, and butter. Avoid high omega-6 fatty acid consumption, as in vegetable oils. Of course, avoid trans fats. Good fats are saturated, monousaturated, and omega-3s.

He provides a few low-carb recipes, surprisingly without specific carb counts: chapatis, microwave bread, cauliflower pizza, coconut cauliflower rice, shredded cabbage sabji, gajar halwa (carrot pudding), and coconut ladoo.

Dr. Sinha doesn’t provide a comprehensive meal plan. He trusts his California South Asians to figure out how and what to eat. They’re smarter than average (he never says that, but that’s been my experience with South Asians in my world).

Dr. Sinha is also a huge proponent of exercise. He’ll tell you about squats, lunges, planks, burpees, yoga, and Tabata intervals. He agrees with me and Franziska Spritzler that “physical activity is the most effective fountain of youth available.”

Steve Parker, M.D., Conquer Diabetes and Prediabetes

Taking a rest from the fountain of youth


I skipped some of the chapters due to lack of time and interest: women’s issues (e.g., pregnancy, polycystic ovary syndrome, post-partum depression, osteoporosis), childhood, fatigue and stress management, and anti-aging.


  • He likes high-sensitivity CRP testing.
  • His metabolic goals for South Asians are: 1) keep waist circumference under 35 inches (90 cm) in men, under 31 inches (80 cm) in women, 2) keep triglycerides under 100 mg/dl (1.13 mmol/l), 3) keep HDL cholesterol over 40 mg/dl (1.03 mmol/l) for men, and above 50 mg/dl (1.29 mmol/l) for women, 4) keep systolic blood pressure 120 or less, and diastolic pressure 80 or less, 5) keep fasting blood sugar under 100 mg/dl (5.6 mmol/l) and hemoglobin A1c under 5.7%, and 6) keep hs-CRP under 1.0 mg/dl.
  • He says HDL cholesterol helps reduce insulin resistance via apoprotein A-1 (apo A-1), which increases glucose uptake by cells.
  • He likes to follow the triglyceride/HDL ratio. If under 3, it means low risk of insulin resistance being present.
  • He likes to follow total cholesterol/HDL cholesterol ratio: ideal is under 3.5.
  • Statins are way over-used.
  • Ignore total cholesterol level by itself.
  • Stress control and sleep are important.
  • The author had some metabolic syndrome components: high triglycerides, low HDL cholesterol, and type B LDL (small, dense particles).
  • He dislikes the usual-recommended low-fat, low-cholesterol diet.
  • 4 tbsp (60 ml) of extra virgin olive oil daily seems to lower blood pressure.
  • Magnesium supplementation may lower blood pressure.
  • The liver stores about 100 grams of glycogen and muscles store 300–500 grams.
  • Vanaspati is a “cheap ghee substitute” made from vegetable oil and widely used in Indian restaurants and many Indian processed foods. Avoid it since it’s a source of trans fats.
  • Aloo sabji is a potato dish.
  • Traditional Indian herbs/spices include turmeric, cardamon, ginger, and cilantro.
  • Find an Indian medication guide at
  • Coconut milk is a traditional fat in India.
  • Curry, curry, curry.
  • http://www.pamforg/southasian.
  • Non-alcoholic steatohepatitis (NASH) is quite common in South Asians, seemingly linked to visceral (abdominal) obesity and insulin resistance related to carbohydrates.
  • The book has no specific focus on diabetes.


Overall, I like many of Dr. Sinha’s ideas. They seem to be supported by his experience with his own patients. I trust him. I bet many South Asians and non-Asians eating the Standard American Diet would see improved health by following his low-carb, physically active program.

Steve Parker, M.D.



Filed under Book Reviews, coronary heart disease, Heart Disease, India, Overweight and Obesity, Weight Loss

Dietary Advice for a 41-Year-Old South Asian With Prediabetes

The CulinaryRx blogger at MedPageToday asked two physicians what diet modifications they’d recommend for a 41-year-old man with prediabetes. (To read the article you may need to do a free sign-up.)

The moderator asked his experts twice whether carbohydrate restriction is important, and never got a straight answer. These experts must not think it’s important since they push legumes, lentils, fruits, and whole grains. Dr. Nadeau said he believes there is no specific diet for folks with diabetes. I almost fell off my chair when I read one comment recommending cookies and sweets, because they’re traditional. They also recommend low glycemic load, nuts, higher protein consumption, vegetables, and “good oils” like olive oil (ghee not mentioned).

Read this blog post for prior comments that include advice from possible clinicians.

I’m confident that Dr. Ronesh Sinha in Silicon Valley, California, would disagree with the advice of MedPageToday’s experts. Dr. Sinha would likely recommend limiting digestible carbohydrates to 50–150 grams/day as the most important dietary step. (I plan on a review of Dr. Sinha’s book here within a few months.)

I’m still looking for clinical studies of various diets for South Asians (aka Indian Asians) with prediabetes and diabetes.

Steve Parker, M.D.


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