2026.09.10 – Dr Daniel Israel – Metabolic disease:Obesity

0:00IFM 101.9 megahertz of life. Right, let's talk about, let's continue our conversation about metabolic disease. Dr. Daniel Israel joins us this morning. A very good morning. Hope you're well. Morning, Howard. I hope you are doing well. What are you leaving behind? No, no, that's not the question. What does your family want you to leave behind in 5786? Obviously, all my metabolic disease. You see, you got a nice family. My family just wanted me to leave my sneezes behind. So there we go. Right. Daniel, there are so many diets out there. And we often laugh about it at home because we always into this type of thing, but it changes so dramatically. And every diet is the best diet because it's the newest. What is the best in terms of evidence?

1:03So you see how we, as you rightly so, we always hear over the years about how to be proven that this diet or that diet is better. And we certainly saw with the whole sum notes revolution, how low carb was best. And then we, you know, often our patients tell me about how keto diets are best or quite a more diet. But at the end of the day, if you look at the evidence and there's been studies to show this, there is absolutely no overwhelming evidence showing that one diet is better than another diet. And interesting that even includes the Mediterranean diet. So I think what's more important with this kind of space is to look at, you're like, this is a great little opportunity to say that you can, and I'm not a dietitian, that's my disclaimer, but one can summarize dieting into one principle. And that is, if a person is living in a calorie deficit for a period of time, they will lose weight. Yes, there are resistances and medical problems and you can be half a thyroid and not to lose the weight.

2:05But at the end of the day, a normal person will lose weight if they are burning more calories than they are consuming. Now, the way I like to see this with an approach to dieting is to divide dieting into, or approach us to diet into three different ways of doing it. The one is when you eat, the other one is what you eat, and the other one is how much you eat. And all dieting fits into that. So in other words, if you're talking about when you eat, and you make a decision that you're going to restrict the time that you're consuming food in a day, you will naturally consume less calories in the day and be in the, you find it easier to achieve that deficit. So that covers things like intermittent fasting and, you know, if you control what you eat, you now venture into the space of carnival diets or keto diets, or because by me saying, I don't eat carbs, I am making it harder to consume the amounts of calories that otherwise would be...

3:07In other words, it's just finding ways to get back to the same thing, which is calorie restriction. Exactly. And, and in the old methods of, of way less than how much you eat and, wearing your portions, and is just, is then saying, I'll eat whatever I want and whenever I want, but only certain amounts of it. So, to that understand your own psyche and your own behaviour, and what works best for you. Like I said to you, one night, that's in the week, eat less carbs, you can also pull on two levers at the same time. You can send the week I will restrict what I eat, and on chavis, I will restrict the amount that I eat. You know, that is the overall summary of dieting. So, and in terms of protein eating more, is that such a thing? Is there such a thing like that? Yeah, absolutely. So, you know, to dive to our previous discussion last week, where we spoke about how ideas to get our lean body mass up and to get our, add a positive down, which is why this is about metabolic disease, and to get our visceral fat down, especially if you're using gel peas,

4:10or even without that. As we get older, one's lean muscle mess will go down. And as I said last week, I think we are more in a worry of creating a frail generation, than an obese generation. It is very, very important to have enough protein. Now, in the past, there have been a lot of hesitations from different societies about causing renal disease by having too much protein, but the current, like if they're called ADA recommendations on way under estimated, one should have probably between 1.2 and 1.5 grams of protein per kilo per day, which is quite hard to achieve. I mean, if you look at an 80 kilogram person, and you said they need to have about 125 grams of protein. Yeah, it really is. It's like three eggs in the morning, and chicken in the middle of the day, and fish at night, and sometimes you put in a protein shake. But it is, that is an interesting thing, because you always think of dieting as eating less,

5:11but it would be definitely in this space eating more, which also fills you up and helps you achieve your overall calorie deficit, because there's less calories per protein thing than it is per carb thing, or unit. So in terms of your advice around that, would you still advise people to try for this 1.2 grams per kilogram of protein? Yeah, and there's somebody has a standard renal disease on some protein restriction. The one point you should be the minimum. So an interesting thing to do is to go into, I don't know, chat to you, or some online, and put in your weight, and ask it to give you examples of the amount of food you should be consuming per day in the protein space, to be able to fill that space, to fill that requirement. It's really quite difficult. In terms of your own practice, what are you seeing in terms of,

6:11maybe people that are undiet, maybe they're on GLPs, GLP ones, what kind of nutrient efficiencies are you coming across? So interestingly, the thing that we see the most is iron deficiency. It really untreated is, and this is not only amongst vegetarians. So either because people are losing iron, losing iron to the different way that happens to people, and that will do that another time, or because they're not having enough. People are generally sitting where they may be in the acceptable range, but they are really under iron baked, in which case, really, going back to the old things, green, green, leafy fruits, fruits, and protein-rich fruits, but are important. So the other thing is for good iron is what you need to, like vitamin C, really help. So interestingly, taking vitamin C with your iron, so to speak, or what you're having now, will help you absorb it better. Another one we see is vitamin D deficiency, but that's not diet mediator.

7:12That's often sun-larked mediator, but even here in South Africa, that is a problem. Those are definitely the things one would push. Okay, coming up for our Jewish listeners, all of the festivals, the Hageem, not an easy time. What advice do you give them? I mean, not an easy time in terms of managing to control consumption. So we're really trying at the moment for everyone who's in the space to work on these different problems of pharmacological and non-phomacological. And Hageem, a whole month of eating badly, is not a great idea. So one of the, maybe the suggestions I could make is that, like it's about pulling on the levers of type and time. So you could say that at the lunches of the Yodts, you're not going to have more than one or two carbs, like a piece of bread, and then in the sappers, if you feel that that's too restrictive, you're going to have much more. If you say at certain times, you're going to restrict certain things, you are much more likely to end up effective,

8:15consumed over all this calories and be more towards your deficit than in your surplus. And then you make up for it, a series of your matrivers, a time for, or, for hitting yourself on, you can eat as a lot of it, and have no carbs in it. Absolutely, that is where we leave it, Dr. Taino, the Israel-wishing Jewish, and Kammar Khatima, to you. Thank you, as always.