A carnivore diet is a restrictive diet that only includes meat, fish, and other animal products like dairy and eggs. More recently, it has been brought into the limelight by influencers and social media personalities. In fact, there is a whole community of "meatfluencer" who are sharing their meat-eating plans. One of them is Dr Paul Saladino MD, whose belief that there was no better way to prevent chronic diseases than a carnivore diet prompted him to write books and post videos regarding the same. He believed so much in this eating plan that he became a go-to person for many following the same plan, until recently, when he decided to quit.

Here Are Seven Reasons Why He Decided To Quit

Carnivore Diet Disrupted His Sleep

Switching to an all-meat diet isn't always straightforward, especially when it comes to digestion—a lesson Dr Saladino learned firsthand. He experienced sleep disturbances, likely due to the difficulty of digesting high-protein meals. Since protein takes longer to break down, it demands more energy from the body, which can interfere with rest.

According to Johns Hopkins Medicine, digestion slows by up to 50% during sleep. Additionally, many types of meat contain tyramine, a compound derived from the amino acid tyrosine. Increased tyramine intake can lead to health issues and also triggers the release of norepinephrine, a hormone that raises heart rate and blood pressure, making restful sleep harder to achieve.

He also experienced hypnagogic jerks—sudden muscle spasms that jolt the body awake. "I would fall asleep but then jerk myself awake like I was falling multiple times. It was stressful and traumatic, leading to poor sleep," he shared in his YouTube video.

Eating Only Meat May Have Triggered Heart Palpitations

Another concerning side effect Dr Saladino experienced was heart palpitations—episodes where his heart felt like it was racing or fluttering. While stress is a common cause, few would immediately link palpitations to meat consumption.

However, a sudden shift to an all-meat diet can lead to electrolyte imbalances. The elimination of carbohydrates lowers insulin levels, prompting the kidneys to excrete more sodium. This disrupts the balance of essential minerals like potassium and magnesium, which are crucial for heart function.

Muscle Cramps Became Persistent

Dr Saladino also suffered from frequent muscle cramps while following the carnivore diet. In a post on X, he emphasized the importance of maintaining adequate magnesium, calcium, and potassium levels to prevent cramping. He initially believed that animal-based foods provided sufficient minerals, but his ongoing cramps led him to reconsider.

"I started to think maybe long-term ketosis is not great for me,” he admitted on the *More Plates More Dates* podcast. “Probably not a great thing for most humans."

His Testosterone Levels Dropped Significantly

Dr Saladino also saw a decline in his testosterone levels after following the carnivore diet for over a year. "At the beginning of my carnivore experiment, my testosterone was about 800. After a year to a year and a half, it had dropped to around 500," he revealed.

The issue likely stems from excessive protein intake, which can elevate inflammation and disrupt hormone levels. A 2022 study published in Nutrition and Health found that consuming more than 35% of daily calories from protein can lead to various negative effects, including reduced testosterone.

He Had Chronically Low Insulin Levels

Because he largely eliminated carbohydrates—except for a small amount of fruit—Dr Saladino developed persistently low blood sugar. In his YouTube video, he explained, "I had very low insulin because I wasn’t eating carbohydrates, and the protein I consumed wasn’t insulinogenic enough."

While some diabetics report improved blood sugar control on the carnivore diet, its effects vary based on individual metabolic responses. For non-diabetics, low insulin can lead to hypoglycemia, causing symptoms like dizziness, confusion, a racing heart, and, in extreme cases, seizures or coma. Mild cases can be managed with fast-acting carbohydrates like juice or candy, but severe episodes require medical attention.

His Blood Test Results Showed Concerning Imbalances

Lab tests revealed that his magnesium levels were low, while his sex hormone-binding globulin (SHBG) was elevated—both potential red flags for long-term health issues.

A magnesium deficiency can cause numbness, tingling, fatigue, nausea, headaches, and muscle cramps. Since cramps often strike at night, low magnesium may also contribute to sleep disturbances.

High SHBG levels indicate an excess of circulating protein in the blood, which can increase the risk of heart disease, osteoporosis, and depression. To counteract these imbalances, introducing more magnesium-rich foods—such as leafy greens, nuts, beans, and yogurt—could be beneficial.

He Felt Cold All The Time

Electrolyte imbalances and metabolic disruptions can even affect body temperature, which Dr. Saladino experienced firsthand. "I was always cold,"he shared in his YouTube video.

Upon testing his thyroid function, he discovered that his total T3 and free T3 hormone levels were "not ideal." These hormones regulate metabolism, and low levels can slow down metabolic processes, leading to cold intolerance.

Common metabolic conditions such as obesity and diabetes are increasingly becoming a serious public health concern in India. Their health implications extend beyond the conditions themselves, with obesity and diabetes associated with a range of chronic diseases and complications that can affect long-term health and wellbeing. As lifestyles become more sedentary and the prevalence of these conditions continues to rise, understanding their wider implications on women’s health is becoming increasingly important.

What many women may not realize is that this metabolic burden can carry a deeper, less visible consequence one that reaches into the domain of gynecological cancer.

One such concern is endometrial cancer. A form of uterine cancer, it develops in the lining of the uterus and is becoming an increasingly important health issue globally. Yet, many women remain unfamiliar with the disease, its risk factors, and the symptoms that require prompt medical attention.

The Metabolic Health Connection

Increasing evidence points to a link between metabolic syndrome and endometrial cancer, particularly through conditions such as obesity and diabetes. Excess body weight and metabolic disturbances can disrupt hormonal balance, such as by increasing estrogen production without a corresponding increase in progesterone. Over time, this hormonal imbalance may stimulate abnormal growth of the endometrial lining, increasing the likelihood of cancer development.

Diabetes, too, has been associated with an increased risk. As obesity and diabetes become more prevalent, recognizing these less-discussed consequences is an important part of strengthening women’s preventive health.

For women, maintaining a healthy weight, staying physically active, managing metabolic conditions effectively and paying attention to unusual symptoms can all form part of a broader approach to preventive health.

Watching Out For Unusual Symptoms

One of the most important characteristics of endometrial cancer is that it often presents with abnormal vaginal bleeding. Bleeding or spotting after menopause is one of the most significant warning signs and should never be ignored.

For women who have not reached menopause, heavier-than-normal periods, prolonged bleeding, or bleeding between periods should be discussed with a healthcare professional.

Why Awareness Matters

Improving awareness is important because there is currently no recommended routine screening test for endometrial cancer in asymptomatic women. As a result, recognizing symptoms and seeking timely medical advice are among the most effective ways to support earlier diagnosis.

At the same time, the conversation should not end with cancer awareness alone. As India continues to face a growing burden of obesity and diabetes, prioritizing metabolic health has become increasingly important for overall wellbeing.

Maintaining a healthy weight, staying physically active, eating a balanced diet, and effectively managing conditions such as diabetes can help reduce the risk of a range of serious health complications, including certain cancers. For women, understanding the connection between metabolic health and endometrial cancer can empower more informed decisions about prevention, symptom recognition, and long-term health. By addressing obesity and diabetes early and seeking medical advice when unusual symptoms arise, women can take meaningful steps towards protecting their health at every stage of life.

(By Dr. Shefali Sardana, Medical Oncologist, Apollo Hospitals, New Delhi)

Melanoma is often considered one of the more challenging cancers to treat, particularly when it has spread to distant organs. For early-stage disease, surgery remains an important treatment option. But once melanoma reaches stage IV, treatment becomes considerably more complex.

Understanding The Biology Of Advanced Melanoma

According to Dr. Mandeep Singh Malhotra, Cheif Mentor AOHC, cytotoxic chemotherapy has traditionally had a limited role in melanoma, while immunotherapy has changed the treatment landscape for many patients.

When melanoma is detected at an early stage and can be completely removed, surgery is generally considered the preferred treatment. Depending on the disease, this can involve removal of the primary tumour and assessment or treatment of regional lymph nodes.

But stage IV melanoma presents a very different challenge.

A Complex Case With Multiple Tumour Sites

Dr. Malhotra recalls the case of Sarah, who came to the team with multiple nodules in the scapular region. There were also lesions on both legs and a lesion in the pancreas. So there were multiple nodules. One in the right side of the leg, another in the left side of the leg. And there was a lesion in the pancreas.

Rather than relying on a standard treatment approach alone, the team first tried to understand the biology of the disease. As a standard protocol for this type of case, we first try to understand the disease biology. In Sarah’s case, the team used extensive testing, including chemosensitivity testing, transcriptomic analysis and next-generation sequencing.

Also read: Cancer Should Be Made Notifiable In India, Say Experts: Here’s Why

When Imaging Initially Suggests Progression

The results suggested sensitivity to certain drugs. When we analysed those reports, we were able to understand that cytotoxic drugs like temozolomide were effective. And checkpoint inhibitors like pembrolizumab, nivolumab were effective.

Based on these findings, the team developed a treatment protocol in which the main component was an immune checkpoint inhibitor along with low-dose temozolomide. Other agents, including lower doses of anti-VEGF, anti-FGF and CDK inhibitors, were also incorporated based on the analysis.

After around four weeks, the response became difficult to interpret on imaging. The PET scan suggested that all the lesions have had a pseudo progression.

Pseudo progression is a recognised phenomenon during immunotherapy. A tumour may appear larger initially because of immune-cell infiltration, even when the treatment is actually producing an anti-tumour response.

This is particularly relevant in melanoma treated with immune checkpoint inhibitors. However, doctors cannot simply assume that every apparent progression is pseudo-progression; true progression must also be considered and confirmed through Histopathology

Also read: French Court Links Flight Attendant’s Breast Cancer To Workplace Radiation; How Does Flying Increase Cancer Risk?

Histopathology Reveals A Dramatic Treatment Response

The team then proceeded with surgery, removing the nodules from the scapular region and both thighs. The specimens were sent for histopathological examination. And histopathology results were amazing. The tumours had gone necrotic.

The pathology showed extensive treatment-related changes, with inflammation and fibrosis around the nodules and only small areas containing viable melanoma cells.

Also read: _{Daraxonrasib: US FDA Approves Once-Daily Pill for Metastatic Pancreatic Cancer}

What Comes Next For The Patient?

For now, the plan is to continue the treatment for a few more cycles and then reassess the pancreatic lesion. The team is considering NanoKnife (irreversible electroporation) for the pancreatic lesion followed by Vaccines.

Certain cancer vaccines are being developed in certain labs in Germany and Europe and they are available for our patients in India on compassionate grounds. It's a very, very good response. And to achieve disease NED in stage four melanoma, I think we are really lucky and it's all due to the grace of God.

Why Individualised Treatment Matters In Stage IV Disease

The case also highlights an important point about advanced melanoma: treatment may need to be individualised according to the biology of the disease and the patient's response. At the same time, he stresses the need for hope. I hope that more people can benefit from this protocol and use this protocol to treat melanomas across the world.

For Sarah, the journey is still ongoing. The next step will be to reassess the pancreatic lesion and determine whether further local treatment can help achieve no evidence of disease (NED). A stage IV melanoma involving multiple sites, including the pancreas, reaching a point where NED may become a possibility is certainly an encouraging development. But it remains an individual clinical experience, rather than proof that the same protocol will work for every patient with metastatic melanoma.

By Dr. Mandeep Singh Malhotra, Director of Surgical Oncology at CK Birla Hospital and Chief Mentor at AOHC

People living with obesity and diabetes often feel healthy in their day-to-day life, but some of the most dangerous changes may be happening silently inside their bodies.

The liver is one of the first organs to be affected. In many cases, fat slowly accumulates in the liver without causing any pain, discomfort, or obvious symptoms. This is why fatty liver disease is often called a “silent condition.” By the time it is detected, it may already have progressed to an irreversible stage.

Excess body fat, particularly around the abdomen, disrupts how the body processes sugar and fats, placing continuous stress on the liver. Because of this silent progression, experts now strongly recommend that people living with obesity and type 2 diabetes should proactively check their liver health, even when they feel completely well.

Obesity is closely linked with liver damage through a series of metabolic changes that develop over time. When the body becomes resistant to insulin, fat begins to accumulate in liver cells, triggering inflammation and gradual injury.

If this continues unchecked, the condition can progress from simple fat accumulation to more serious stages, including metabolic dysfunction-associated steatohepatitis (MASH), where inflammation and liver cell damage become more significant.

Over time, this may lead to fibrosis (scarring of the liver), and in advanced cases, cirrhosis, which can severely affect liver function. Further, patients with fatty liver may directly present with liver cancer, which can occur in up to 20% of patients.

How Common Is Fatty Liver In People With Diabetes And Obesity?

In India, the burden of metabolic dysfunction-associated steatotic liver disease (MASLD) or fatty liver is rising and is now recognised as a common metabolic condition. Studies from the Indian subcontinent estimate that 1 in 3 people may have MASLD. Fatty liver is particularly common among individuals with metabolic risk factors.

It is seen in nearly 40–80% of people with type 2 diabetes and 30–90% of those with obesity, often without clear symptoms.iv Hospital-based trends also suggest increasing detection in younger age groups, reflecting changes in diet, reduced physical activity, and more sedentary lifestyles.

Also read: Post-Menopausal Women Face A Higher Risk Of Fatty Liver Disease: How Falling Estrogen Levels Impact Liver Health

What Liver Checks And Preventive Measures Should You Follow?

Preventive measures to be followed:

• If you live with excess weight/obesity and type 2 diabetes or PCOS (polycystic ovarian syndrome) or dyslipidemia, seek early consultation with a physician or hepatologist.

• Your doctor may request routine metabolic screening:

• Regular liver function tests as part of annual health check-ups

• Ultrasound screening for individuals with obesity or diabetes

• Monitoring blood sugar, cholesterol, and triglyceride levels

• Liver scarring scan (annually for patients with diabetes/obesity)

• Avoiding long-term neglect of “mild” or borderline test results

Also read: From Liver Inflammation to Cancer: When Hepatitis Becomes a Serious Warning Sign

With rising obesity rates in India, early liver screening should become a routine part of preventive healthcare. Even modest weight reduction, improved diet quality, and regular exercise (approximately 150 minutes per week of moderate-intensity exercise (example: brisk walking, gardening, swimming, cycling) or 75 minutes of vigorous exercise (example: weight training) can significantly reduce liver fat and inflammation within 3-6 months.

However, once the disease progresses to MASH or fibrosis, reversal becomes more difficult and may require long-term medical management. Early-stage fatty liver disease is reversible in many cases. In fact, medications can even reverse liver fibrosis (early scarring), but in only 25% of patients. Simple homemade food is sufficient to prevent these lifestyle diseases, and there is no need for “fancy online diets or supplements”.

Our forefathers lived longer by consuming homemade food and water without any supplements. Newly approved therapies such as semaglutide (GLP1 analogues) have been shown to resolve steatohepatitis and reduce liver fibrosis. These liver benefits do not appear to be explained solely by weight loss, suggesting a broader potential impact on liver health.

The absence of symptoms does not mean the absence of risk. Taking care of the liver early is not just about preventing disease; it is about protecting long-term health, energy, and quality of life.

By Dr. Anand V. Kulkarni, Senior Consultant Hepatologist & Director – Critical Care Hepatology, AIG Hospitals, Hyderabad