The Hidden Metabolic Crisis Affecting Millions of Southeast Asians

South Asians develop heart disease, diabetes, and metabolic dysfunction at dramatically higher rates than almost any other population—but why? In this episode, Dr. Sanjay Bhojraj is joined by functional medicine practitioner Shefaly Ravula to unpack the unique biology behind South Asian metabolic health. Together they explore the "thrifty gene" hypothesis, insulin resistance, muscle loss, continuous glucose monitoring (CGMs), gut health, personalized nutrition, cholesterol testing, and why traditional risk factors often miss the bigger picture. They also discuss practical strategies for improving metabolic health, including building muscle, optimizing protein intake, improving blood sugar regulation, interpreting advanced lipid testing, and adapting traditional Indian foods without abandoning cultural identity. Whether you're South Asian or simply interested in longevity, prevention, and precision medicine, this conversation offers actionable insights into one of today's biggest health challenges. Together they discuss: - Why South Asians have unique metabolic risks - The truth about insulin resistance - Continuous Glucose Monitors (CGMs) - Muscle, longevity, and blood sugar - Advanced cholesterol testing - Functional medicine vs conventional medicine - Gut health and inflammation - Traditional Indian diets - Protein myths - Precision nutrition Timestamps 00:00 Introduction 01:00 Meet Shefaly Ravula 02:15 From Gastroenterology to Functional Medicine 05:30 Why Lifestyle Medicine Comes First 07:00 Precision Medicine vs Traditional Medicine 08:20 Why South Asians Develop Heart Disease Earlier 10:30 The Thrifty Gene Hypothesis 13:00 Why "Skinny" Doesn't Mean Healthy 15:15 The Muscle Deficit in South Asians 17:00 Continuous Glucose Monitors Explained 21:00 Why HbA1c Isn't Enough 23:30 Should Healthy People Wear CGMs? 26:30 The Functional Medicine Lab Panel 31:00 The Indian Diet Problem 38:00 Protein, Muscle & Longevity 41:00 White Rice vs Brown Rice 45:00 Cooking Oils: Seed Oils, Ghee & Olive Oil 50:00 Ancient Wisdom Meets Modern Science