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.

Non-healing mouth sores are often brushed off as minor issues, but when they persist for more than two weeks, they can signal something more serious.

Mouth ulcers are common and are often caused by stress, minor injuries, or nutritional deficiencies. Sores that do not heal may indicate underlying health concerns, particularly oral cancer.

"Early-stage oral cancers can present as painless ulcers or patches inside the mouth, making them easy to overlook. Conditions like Oral Cancer, Leukoplakia, or Lichen Planus may initially appear as harmless lesions but can progress if left unchecked," Dr. Mandeep Singh Malhotra, Director – Surgical Oncology at the CK Birla Hospital, Delhi, told HealthandMe.

Dr. Tejinder Kataria, Chairperson - Radiation Oncology, Medanta Hospital, Gurugram, added that mouth sores that don't go away after two to three weeks could be an early sign of oral cancer.

"These sores can be red or white and hurt or bleed easily. This is not the same as regular ulcers," he told HealthandMe.

The experts noted that non-healing sores can also be associated with systemic conditions such as

• vitamin deficiencies (especially B12 and iron),
• weakened immunity,
• chronic infections.

What Is Oral Cancer?

Also read: CDC Delay In Infant Hepatitis B Shots May Surge Infections, Deaths In US: Research

Oral cancer is a wide term for cancer that affects the inside of your mouth, and it typically presents itself as white patches or sores that bleed. It can occur on the:

• Lips.
• Gums.
• Tongue.
• Inner lining of the cheeks.
• Roof of the mouth.
• Floor of the mouth

It is estimated that about 60,000 new cases of oral cancer are reported annually in India, and five people die from the condition every hour. It is the most common cancer in Indian men and the third most common in women, with roughly 20 in 100,000 people affected.

Signs To Watch For

Oral cancer grows slowly, and the first signs usually don't hurt, so a lot of people don't notice them. However, it's important to look out for

• a change in voice,
• a lump in the mouth,
• trouble chewing
• A lip or mouth sore that won't heal.
• A white or reddish patch on the inside of the mouth.
• Loose teeth
• Mouth pain
• Ear pain
• Difficult or painful swallowing.

• Not brushing teeth,
• Tobacco use,
• Alcohol consumption,
• Ill-fitting dental appliances

How To Prevent

Early diagnosis plays a crucial role in effective treatment. If a mouth sore persists, grows, or is accompanied by pain, bleeding, or difficulty swallowing, it is important to consult a healthcare professional promptly. Paying attention to such small signs can make a significant difference in long-term health outcomes.

• Avoid smoking,
• drinking alcohol,
• Eat a lot of fruits and vegetables
• Keep your mouth clean.
• Going to the dentist regularly can help spot changes early.

Knee replacement surgery has witnessed remarkable advancements over the past few years. Traditionally, total knee replacement was performed as a uniform procedure ("one procedure fits all"), where the entire knee joint was replaced regardless of the extent or location of damage.

However, with the evolution of modern orthopedics, the focus has shifted towards precision and personalized treatment. In this direction, an A La Carte or Modular approach towards patients who need knee Replacement has emerged, which customizes or personalizes the surgery according to the patient’s specific condition.

Understanding The “à la carte” Concept

The term “à la carte” refers to selecting individual items from a menu. In knee replacement surgery, it means replacing only the damaged portion of the joint instead of the entire knee.

The knee is anatomically divided into three compartments:

• Medial compartment (inner side)
• Lateral compartment (outer side)
• Patellofemoral compartment (front portion involving the kneecap)

In many patients suffering from osteoarthritis, the disease affects only one or two of these compartments—most commonly the medial compartment. In such cases, replacing the entire knee may not be necessary. Modular implants allow surgeons to selectively treat the affected area while preserving healthy bone and ligaments.

The à la carte technique helps preserve the natural structure of the knee while effectively treating only the damaged portion, resulting in better and more natural functional outcomes for patients.

However, this approach is not suitable for all patients. It is generally not recommended in inflammatory conditions such as rheumatoid arthritis.

How It Differs From Total Knee Replacement

In Total Knee Replacement (TKR), all three compartments of the knee are replaced, making it an effective solution for advanced and widespread arthritis.

In contrast, Modular Knee Replacement offers a more targeted approach:

• Replacement of a single compartment (Partial Knee Replacement)
• Replacement of two compartments (e.g., medial + patellofemoral)

This selective treatment helps maintain the knee’s natural structure and function.

Advantages Of The Modular Approach

For carefully selected patients, this technique offers several important benefits:

• More natural knee function: Preservation of ligaments and bone provides a more natural feel.
• Faster recovery: Less invasive surgery leads to quicker rehabilitation.
• Reduced pain and blood loss: Minimal surgical trauma results in less discomfort.
• Improved mobility: Patients often achieve a better range of motion.
• Enhanced lifestyle comfort: Activities like sitting cross-legged or squatting may be easier and can be done unrestricted compared to total knee replacement.

Who Is the Ideal Candidate?

Not every patient is suitable for this procedure. Proper patient selection is one of the most critical factors in ensuring the success of this procedure. Ideal candidates typically include people:

• Having arthritis limited to one or two compartments
• Having stable knee ligaments
• Who do not have a severe deformity in the knee

Long-Term Outcomes

When performed in the right patient, modular knee replacement delivers excellent long-term outcomes (90 to 95 per cent survivorship for 15 years). Its success largely depends on accurate patient selection and flawless surgical expertise.

In some cases, if arthritis progresses in the remaining compartments over time, conversion to total knee replacement can still be done. However, this is relatively uncommon when proper indications are followed.

Role Of Robotic Technology

Robotic-assisted surgery has further enhanced the precision of this technique. It enables:

• Millimeter-level accuracy
• Precise implant positioning
• Restoration of patient-specific knee alignment

Conclusion

Ala Carte or Modular Knee Replacement represents a significant shift toward personalized orthopaedic care. Instead of a "one-size-fits-all " approach, surgeons can now tailor treatment based on the patient’s anatomy and disease pattern.

For many patients, this means less invasive surgery, faster recovery, improved function, and a more natural-feeling knee. Individuals experiencing persistent knee pain are advised to consult an orthopaedic specialist early to determine the most appropriate treatment option.

Beyond lung cancers, air pollution fine particulate matter (PM2.5) is increasing mortality for breast as well as liver cancers, according to a global study led by the Union for International Cancer Control (UICC), including researchers from the Indian Council of Medical Research (ICMR).

The important study showed that long-term exposure to PM2.5 increases the overall risk of developing cancer and the chances of dying from it compared with those living in cleaner environments.

For every 10 micrograms per cubic meter (µg/m³) increase in PM2.5 exposure, the overall risk of cancers increases by more than 11 per cent. At the same time, the risk of death also increases by more than 12 per cent for every 10 µg/m³ increase in PM2.5 exposure.

The researchers argued that while other common risk factors like tobacco and alcohol are being targeted with notable progress, air pollution is silently eroding the gains being made.

“We have made huge strides in reducing deaths from cancer, but polluted air is silently undermining that progress. It is a risk people cannot opt out of, and one that disproportionately affects women, children, and people living in poverty,” Cary Adams, CEO, UICC.

“The cancer community continues to make progress in addressing other major risk factors, including tobacco use, alcohol consumption, and viral, bacterial, or parasitic infections such as HPV and HBV that cause cervical and liver cancers. It is increasingly clear that air pollution must also be recognized as a major and preventable factor that increases the risk of developing cancer and of dying from the disease,” added Dr Elisabete Weiderpass, Director, IARC.

Risks of PM2.5: Beyond Lung Cancer

The study, based on data from 42 meta-analyses and systematic reviews published between 2019 and 2024, showed significantly strong associations for liver, colorectal, and breast cancers.

As per recent data from the International Agency for Research on Cancer (IARC), PM₂.₅ exposure contributes to 434,000 lung cancers per year, accounting for more than a quarter of preventable lung cancers in women and nearly one in six in men.

In addition to lung cancer risk, the study noted that the rising levels of PM2.5 are associated with

• a 32 per cent higher incidence of liver cancer
• an 18 per cent increase in the odds of developing colorectal cancer.

• a 12 per cent higher overall risk of dying from cancer,
• a 20 per cent higher risk of death from breast cancer,
• a 14 per cent from liver cancer,
• a 12 per cent from lung cancer.

Who Is At A Higher Risk

According to the researchers, people living in low- and middle-income countries bear the greatest overall burden. These countries frequently lack the resources to reduce pollution at source or to provide timely access to cancer prevention, diagnosis, and treatment.

The challenge is compounded by the projected rise in global cancer cases, expected to increase from 20 million in 2022 to 35 million by 2050. People at risk include:

• Women and children, particularly in settings where solid fuels are used for cooking and heating.
• Women exposed to household air pollution face a 69 per cent higher risk of lung cancer, alongside increased risks of cervical cancer.
• Outdoor workers and communities living near industrial facilities are also at heightened risk, with exposure often concentrated in economically deprived areas.

What Actions Are Required?

The researchers underscored that the evidence presented in the report is already sufficient to justify decisive action to reduce exposure to polluted air. They called upon policymakers to make required changes across energy, transport, industry, and urban planning to reduce the risk of cancer from air pollution.

The study urged the need for properly implementing effective interventions that are well-established. These include:

• Stronger emissions standards and enforcing the WHO air quality Standards
• A transition to clean energy and clean cooking
• Improved urban design by investing more in green infrastructure
• Expanded air-quality monitoring in High-Risk Areas
• Update cancer control plans.