Q: My husband and I are in our mid-forties and we see ourselves ageing with a growing paunch and wrinkles. We realise that the ravages of time are inevitable. What advice can you give us to keep them at bay? What tests can we take to understand our state of health from within? We exercise, do not smoke, and eat in moderation but yet the middle age spread is spreading. HELP…

A: My specialty is Personalised Medicine and so I follow the “different strokes for different folks” motto. In my practice, the most common reasons for belly fat and premature ageing is insulin resistance, and a dysregulated stress response, both of which are inter-related.

Understanding Insulin Resistance

This is a condition where insulin – the hormone produced by your pancreas – does not function as efficiently as it should. The results of this are increased blood-sugar levels, which can lead to Type 2 diabetes, dementia, heart disease, stroke, and cancer. One of the most common causes of insulin resistance is increased carbohydrate intake. When you eat more carbohydrates than your body can tolerate, it gets stored as fat. Some people are severely carbohydrate intolerant, and don’t even know it. For them, their daily carb intake sometimes has to be as low as 20-25 grams. This is particularly true for people of South Asian ethnicity. Sugar, cane sugar (jaggery), and low calorie sweeteners like aspartame, saccharin, and sucralose are ingredients to stay away from.


Most low-fat diets are high in carbohydrates, and this is one of the main reasons why it is important to know your fats.

AThere are good fats and bad fats. Avocados, nuts, and olive oil are examples of good fats. Trans fats, found in most processed foods, are bad fats, which act as a slow poison to your body.


Chronobiology is the study of body rhythms, which, in turn, decide your metabolism. Meal times also play a big role in your health and well-being. It has shown that irregular mealtimes, and late meals can make you gain fat. The latest study to prove this comes from Dr. Satchidananda Panda from the Salk Institute, California, reported in the journal Cell Metabolism in November 2015. His app, myCircadianClock can help you track your daily lifestyle to better understand your body’s rhythms.

Dysregulated Stress Response 

Besides insulin, the other fat-feeding hormone is cortisol. When you have a dysregulated stress response, your body stores fat because it is in survival mode. Low testosterone in men is related to insulin resistance as well as muscle loss.

And finally, as far as wrinkles go, you will have to see a well-qualified aesthetician. But always remember – beauty comes from the inside as well as outside.

Dr. Shabnam Das Kar is a specialist in Functional Medicine – a specialty of advanced science-based personalised healthcare. She is the first doctor from India to have completed the Advanced Fellowship in Antiaging, Regenerative & Functional Medicine from the American Academy of Antiaging Medicine (A4M). She is currently pursuing her Master’s Program on Metabolic & Nutritional Medicine from the University of South Florida.