Building the Foundation: Why Sleep, Movement, and Metabolic Stability Matter More Than Optimization

Movement is much bigger than exercise. Something that improves your sugar regulation, your blood circulation, your mood, your brain function. You are moving to keep your metabolism away. A brisk walk after meals taking scares or getting up every hour. Movement is something your body is designed to do throughout the day. That's real medicine.

Welcome back to Intentional Medicine with Dr. Sing, the podcast where we explore what it truly means to design health inside a system built to manage disease. And today we're talking about something that sounds almost too simple to deserve a full episode: sleep movement and metabolic stability. But here's the truth. In a world obsessed with peptides, hormone optimization, and advanced diagnostics, the most powerful interventions are still the foundational ones. And without them, nothing else works the way it should. So before we talk about what to add, we really need to talk about what to build. So, Dr. Singh, this is such an important episode. I'm excited to talk about this with you and hop into it. But how are you? How's everything been before we dive into the episode? I am doing good, Lela. Thank you so much. I'm also really excited about this episode. Absolutely. I think that with everything going on in media and for, you know, hormone optimization hormone therapy and um GLP1s and peptides and all these things going on, we're always talking about adding and adding, but we need to kind of get back to the foundation because without that, nothing else is gonna work. So let's kind of just like hop in with that being said. So, why do you think that patients and even clinicians sometimes kind of skip the foundational work in favor of some more advanced interventions?

Lela, you know, I'm so glad that we are starting from this question because the honest answer is, you know, the basic, they aren't exciting. Nobody feels like, you know, pioneering for going to bed earlier. Um and when patients they read about this new peptides, hormone protocol, feels like, you know, some insider knowledge, like they have unlocked something most people don't have access to. And on the other side, if we say, you know, sleep more, move more, sounds like something their grandmother told them. They don't take that as a sign. And you know, the truth is that clinicians, even they aren't immune to this phenomena either. Because we are trained to intervene, we are trained to prescribe, we are trained to, you know, do something. So just simply saying that, hey, you know what, let's protect your sleep for eight hours before we touch anything doesn't seem like medicine to a lot of people. In fact, it feels like a delay, and we are not trained to delay things in medicine, we are trained to act immediately. So, you know, it is so intriguing that we live in a world where people are constantly looking for next rate group. They want peptide, they want hormone protocol, they want advanced lab, US longevity protocol. And I completely understand this desire because these advancements are indeed exciting. But you know what? I often tell my patients, you are looking for software upgrade when your operating system is still malfunctioning. So the truth is that advanced therapies can be incredibly helpful. But you know what? We they work best when your foundation is on ready.

No, absolutely. And I think what you said is so true. I think everyone wants to add things. They think it might be faster, might be a quicker route when sometimes it's really just about the foundation, like you said, go to sleep earlier, something your grandma said, for example. But it's kind of like those foundational things we still need, even if we do add things on it. But it's sometimes we've heard it all before. We want something new to just help and make an instant kind of change, is I think where a lot of people's minds tend to go. But what do you think, or actually what does metabolic stability actually really mean? I feel people say that term a lot, but may not really actually understand what it means. And beyond that, why is it the platform that everything else really builds on?

Yeah, as you said, Laila, that a lot of people don't understand the metabolic stability as you know what exactly it means. It is one of those terms that gets thrown around a lot. So, you know, if simply put it together, it's body's ability to create and use energy efficiently without any dramatic swings in blood sugar, insulin, hunger, mood, or energy levels. I'm sure you know some people who feel energized all day, they don't crash at 3 p.m., they are, you know, they don't crave for sugar all the time. So these are usually the signs of better metabolic stability. On the other hand, you know, you know, if you're hungry every two hours, if you're relying on coffee to function, or if you're reaching out for snacks just because your energy keeps crashing, that means that your metabolism is sending signal that something isn't working efficiently. So think of metabolic stability as a foundation of house and everything else, whether it's hormone, whether it's you know your recovery, whether it's brain function or longevity, it's built on top of it. So when the foundation is stable, everything uh, you know, other on every system, um, they built on that. But if the foundation is unstable, then every system struggles. So metabolic stability is very important when we are talking about wellness and longevity.

And then another thing that's talked about and is definitely foundational, but people I think neglect sometimes or neglect the importance of it is sleep. And sleep, I think, is often treated as a lifestyle preference. But how do you frame it clinically with your patients?

Oh, Lela, you know what? My personal goal to educate people on sleep and stop them from thinking of it as a luxury. As you just said that, you know, this is one of the most neglected things. So I just want to say that sleep is not a reward for finishing your work. In fact, sleep is a biological maintenance because during sleep, your brain clear, waste product, your hormone reset, your tissue repair, and your nervous system recovers. So when I talk to people, I frame sleep the same way I would frame a blood pressure or sugar control. Because it's a clinical parity. So I actually treat it like a vital sign, like your blood pressure, your heart rate, I also treat sleep in the same category. Um, I'm sure you have also heard that, you know, I frequently hear successful people, you know, or professional or busy, you know, executives saying that, oh, I'll sleep when I'm dead. Um and anytime when I hear that, I usually smile. I don't say out loud, but in my mind I say that, you know, actually it's a poor sleep, is one of the fastest ways to get you there sooner. Because sleep isn't a passive process, it is one of the most active healing processes that your body performs every night.

Absolutely, yeah. You hear that that term, and I I had a conversation similar to this in another show, but with with sleep, it's one of those things that I think people kind of neglect in a sense. And like they say, sleep when you sleep when you're dead, and coming out of like um, you know, such a work culture of oh, I need to grind and hustle, and and you know, sleep will get only sleep two hours a night or something along those lines. And sleep is actually so important to just function properly and really feel your best, and people definitely put that off. And insufficient sleep is something that can really be detrimental. So when someone's sleeping, what actually happens to the body hormonally and metabolically during a poor or insufficient sleep versus a good night's sleep?

Yeah, you know, Lila, this is where the science really gets fascinating. Um, you know, when you're sleep-deprived, cortisol, I'm sure you know that that's your stress hormone. Uh, it tends to stay elevated when ideally it should come down. And, you know, there are some hunger hormones. I'm sorry, I'm gonna use some medical terms, but you know, they also shift. Like ghrelin, it's one of the hormones which normally tells that, you know, um eat that goes up. And the leptin hormone, which normally says that, you know, you are satisfied to stop eating, that goes down. So after uh, you know, uh insufficient sleep or sleepless night, next day you are hungrier, you are harder to satisfy, although you haven't done anything wrong. But your chemistry changed overnight. Even a single night of poor sleep can measurably reduce your insulin sensitivity next day. So your body handles the exact same meat worse than it did yesterday. Um, but if you take a deep sleep, then lot of repair and growth hormone activities actually happens. So, you know, if you're not sleeping well, you are losing your body recovery. So it's almost like your your biology is, you know, working against you. Just to share, you know, I I let me share one example. You know, I have one patient, um, that patient, you know, was really frustrated uh when she came to us. The reason was she wasn't losing weight despite eating well and being on GLP one, as you know, in this episode we are talking about foundational work on the one side and you know optimization on the other side. So I think this patient was a perfect example because um she was eating okay and she was on you know advanced treatment like GLP, despite that she was not losing weight. So when I sat down with her, we when we dig deeper, we learn a little bit more about her sleep pattern. So she told us that, you know, she sleeps maybe five, sometime, you know, five and a half hours, sometimes she goes to bed late, and whenever she sleeps late, she tends to have a binge eating that time. So, you know, I I spent some time with her and I told her, let's focus on your sleep and you know, improve it from five to six hours to perhaps seven to eight hours and bring some consistency to that, you know, go to bed at the same time, regardless whether you are sleeping or not, because that's gonna eventually improve your routine. So, what happened that once she started doing that, her cravings decreased dramatically and she's eventually started losing weight. So the weight loss that became a task for her earlier became way easier without changing her medication dose or calorie intake. So occasionally, you know, the problem is is not about discipline, it's actually the lack of recovery and that happened when you don't have sufficient sleep.

Absolutely. That's something that I've I've learned recently too, especially with talking to physicians, and like what you just said as well, is that sleep is actually such a big part of recovery. Like if you don't have the sufficient sleep and you keep going and going, you're not gonna recover, and your body's not gonna really be able to do what it needs to do to keep going and and see, especially if you're looking for specific results. And with that, movement is an is another thing that we're talking about today, and movement is that second pillar. So, what's the difference between exercise for, let's say, appearance versus movement for metabolic function? Are they different at all?

Or they are, they are so you know, when most people hear about exercise, they picture a gym, bodybuilding, or you know, the dose heavy machine, cardio workout. But you know, movement is much bigger than exercise. Because movement is something that improves your sugar regulation, your blood circulation, your mood, your brain function, and your energy production. So the beautiful thing is you don't have to look like anything to get the metabolic benefit. A brisk walk after meals or taking stairs or getting up every hour, that's real mind medicine. So when it comes to movement, I fully reframe it completely different. Uh I normally tell patients and clients and people that you are not exercising to earn a body, you are moving to keep your metabolism away. So, you know what, when it comes to exercise, exercise is something you schedule, but movement is something your body is designed to do throughout the day. So, you know, even if you work out for an hour and you think that, oh, you have done a good exercise, but if you are sedentary and you spend remaining 23 hours sitting on your couch or on your chair, that is not a movement at all. And you are not going to get the benefit that you are truly looking for from that workout. So the goal is in fitness, but creating a body that functions metabolically well. And when we talk about that, movement is very crucial for that.

Absolutely. And speaking about movement and exercise, resistance training is something that gets a lot of attention and I think a lot of talk about more recently, but it specifically gets a lot of attention, I think, when it comes to longevity and in longevity circles. So, why and what does evidence actually say about resistance training and longevity?

Yeah, so if I had to pick uh, you know, one form exercise for the longevity, it would be resistant training because you know the resistant training is something that aims to make your muscle stronger. And as we discussed earlier, you know, muscle is not just for the appearance, it is an organ of metabolic health. So resistant training uh, you know, it helps to regulate your blood sugar, it improves your insulin sensitivity, it supports your balance, it protects bone density. Um, so it it really, you know, supports the longevity and wellness. Um, you know, I often tell patients um after age of 30, either we are building muscle or we are losing it. So, you know, I always say that I'm not asking you to become a bodybuilder. I'm simply asking you to keep depositing into your muscle and bone account so that your body can withdraw from it when it fully needs it. Um the let me share another example. You know, one of my patients, she was, I think, in you know, early 60s. She came to us um you know as she wanted to improve her wellness and uh longevity, but she was not a candidate for hormone replacement therapy. So she was looking for alternative means, and when we started talking, uh I shared a lot of things, but one thing I stressed upon was resistant training. I told her, you know, you should have resistant training to two to three times a week. And Lela, you will be surprised, out of all the conversation, somehow she took that, you know, advice very seriously, and she started doing that um very religiously. And six months later, she came to us. She wasn't just a stronger, but I saw her blood sugar improve, her balance improve. She told her us that, you know, she felt more confident um whether when she goes uh to shopping or she carries grocery, and she feels more energetic and steady when she plays with her grandchildren. So I think that's the longevity in real life. Not living only longer, but living better. I think that patient is the best example of um that kind of the longevity that we are discussing here.

Absolutely, it has such a change in the quality of life. And I've had I've heard that example from physicians before about just being able to play with their grandkids and those little every day-to-day things can just make your life overall so much better in ways you wouldn't potentially even sometimes think about. So I think that that that's very, very true when it comes to to longevity and and quality of life overall. And what's your clinical experience with patients who come to you maybe kind of already into optimization protocols, but haven't really addressed sleep or movement consistently with them their day-to-day?

Yeah. These days I see this often. Uh, and let me share another patient example because I think he's the almost perfect illustration of this. 49-year-old, an executive, brilliant driven, very intelligent man. You know, he came in with a binder. I mean, a literal binder. He had maybe, you know, 50-60 panels uh that he got somewhere outside. And he was on testosterone therapy, he was on a couple of peptide and probably 10 to 12 supplements. Um, he was wearing a continuous glucose monitor, he also had an aura ring, you know, the whole arsenal. He had spent a small fortune. But the sad part was he was still frustrated because he still felt flat, he was tired, he was foggy, and he was not seeing the result that he had been promised based on, you know, again, these advanced uh treatment protocols. So um we sat down, I asked him, you know, two important questions. First, how are you skinny pain? And second, how are you moving? Because he told me about his profession. So uh he said that he hardly gets time to sleep, maybe five, five and a half hours uh every night, and then he traveled a lot. So he couldn't remember even the last time, you know, he had worked out because he didn't have time for that, and because of his busy schedule, his diet was all over the place too. So uh, you know, I said to him, as I said, he was a well-educated and very intelligent guy. So I was very polite to him, and I told him very kindly as I could that, you know, you have been renovating your penthouse when your foundation is crappy. So we did something that felt almost too simple. In fact, he was skeptical about it. I said, you know, let's try something that you never thought about. Let's protect your sleep. And when I said sleep, a real window, a consistent schedule. No, you know, going to bed at the same time and you know, having maybe six to seven hours sleep, um, no screen late night, no phone in room because he was a busy man, you know, checking his emails late night. Um, and then I also said that, you know, if you don't have time to do too much workout, at least make a schedule, make a routine of getting up from your chair every hour and adding some small moment into your uh, you know, uh in your day and in if possible add maybe one or two strength uh session. We did not run any single extra test, we did not add any more supplement. In fact, you know, I remove one or two. Um so a few weeks later, um he came back to us and he told us that his energy feels better. And when we look into his monitor, his glucose pattern was better, his mood was improved, his heart rate variability improved, uh, his sleep was not only, you know, better, but the quality of the sleep was also better. So what happened that um the what the that the the result that was he was looking through those protocols um which he had not for months, all of a sudden he started seeing those results. So what struck him wasn't that the advanced tools were wrong, but that they never had a stable platform to work on. And once the foundation was there, everything he had already invested in finally started doing this job. So that's why you know the foundational work is so important.

Absolutely. No, the foundation is is super important, and part of foundation, another pillar that we haven't gotten to yet is nutrition. So, how do you think about nutrition in the context of metabolic stability without you know changing this into a diet, a diet episode?

So, Leila, you know, I work really hard not to make food a model because you know the diet culture has done so much damage there. I'm not here to give anyone a list of forbidden food or promote any particular type of, you know, diet plan. When it comes to, you know, metabolic instability, I only think about three things. Um, that you know, your nutrition supports these three foundational things or not. Number one is uh glucose regulation. So, you know, eating in a way that keeps your blood sugar steady rather than spiking and crashing, which often just means, you know, pairing your carbs with your protein or with your fat or with your fiber instead of eating them naked. Um, second thing that I really want to emphasize is on protein sufficiency because most people, especially as they age, they are not getting um, you know, enough protein to protect their muscle that we talked about earlier. And third thing that is important is your meal timing. Um, not eating in a way that fights your sleep, like having a huge meal right before the bed. So if you notice, Lala, uh, what's not on that list? No guilt, no perfection, or no brand name diet. So, you know, most people they do need perfect diet. What they truly need is a sustainable one. So I always tell my patient, my client keep your diet simple, keep it stable, keep it adequate, and let it support the rest of your system.

Absolutely. And I think that that's something that I've I've Heard a lot as well is just about keeping your diet simple. I think sometimes when it comes to nutrition and diet, I think there's so much information available and so much information that sometimes people and patients we overcomplicate it. We think that we have to do, you know, for example, like even if it's meal prep, meal prep five days of things, or make sure, you know, we have certain things when it just keeping it simple is really just the best, the best thing. I I heard from another show I host, it was kind of like find the few things that you like and just kind of recycle them in different ways. And I I tend to do that, and it's been a game changer for sure.

And I'm sure it must be very simple, right? That's something you can easily accommodate in your busy life.

Absolutely. I'm kind of when you get into a routine of what you're eating, it makes it easier to just kind of get the same things without having to put all like the thought into it. I know for me personally, if I'm overthinking it and then I'm like, well, if I want to make this, well, then I need to get this and then that, and do I have this to make this? And it it it you know, it just makes it so much simple, more simpler if you just kind of keep it the same sometimes. It doesn't always need to be super fun. I I heard that too. It's like almost boring. It seems boring, but when you find the things you like and just kind of repeat them, it makes nutrition a lot more simple to really feel like you're managing well. And let's say if someone comes to you and they're already committed to optimization, hormone, supplements, advanced protocols. What's your honest clinical advice about what really matters most first?

So before I say anything, um, Lela, let me say that, you know, I'm a strong supporter of optimization, advanced tools that we have, you know, available now. In fact, uh I think that we are in most interesting time. Um, you know, right now the medicine, the way the medicine is progressing in supporting longevity and the new and new and newer protocol or regenerative therapies that we are having, that is really fascinating. And I'm I'm also very excited about that. Um but but you know, if someone is fully interested in these um these treatment or or these um optimization protocols, I totally support them. Um because these tools, exploring these tools, are fully uh, you know, appropriate when your body is ready for them. So at Attentive Wellness MD, you know, what we follow, we follow intentional medicine, and this whole episode is about intentional medicine. So what we normally tell people that you know your foundation um is important. So foundation before optimization is crucial. So before adding any further supplement or any advanced protocol, we simply ask you questions, such as, you know, how's your sleep? How's your moment? How stable is your metabolism? Are you recovering well? Uh because you know stacking intervention on top of a weak foundation really produce the lasting results. And I just shared one example in our you know previous question. So optimization is powerful, but sequence matters because optimization is only effective when the basic elements are functioning properly.

And how do you help patients build these foundations sustainably? Not really just as a temporary reset, but really as a permanent way of life.

Yeah, no, that's such an important question, Lela. When it comes to, you know, permanent architecture, I really shift conversation from willpower. Because we know willpower is finite and it fails often when we are uh, you know, under stress, exactly when you need your habits most. So instead of, you know, focusing on willpower, I help my patient design system in their environment as they are default. So the healthy choices, you know, become the easy one. Um and how we do that, you know, one of the ways that we anchor new habits to the things that they are already doing, such as, you know, walk after dinner, because dinner already happens. Um, the bedroom, we really try to make bedroom genuinely a place to sleep. So we ask them not to have a screen in your bedroom. And these days we have also started asking, you know, clients not to have a phone or charger in your room. Please charge your phone in another room. Maybe go back to the old method of having alarm clock in your room. Because we all have this urge to check our phone, to look into a new email, new social media post. So we genuinely want to make you know bedroom a place where you can, your not only you, but your mind can restroom. Uh when it comes to diet, we just discussed, we make, you know, some simple changes such as protein as default at breath pass. It it's not a daily decision that you have to make, but a discipline uh which makes it successful. But you know, in all this conversation, the deepest layer, uh, I focus on identity. Um, I really want my patient to stop saying that I'm trying to sleep more or I'm trying to eat better. Instead of that, I want them to start saying that I'm someone who protects my sleep. Because it's who you are instead of uh you are attempting. And once once you change this narration, it stops being a reset. Uh you have to keep restarting again and again, and it becomes the permanent architecture on which everything else gets to stand. So acting is small action repeated consistently create powerful results over time, um, which are built through daily decision repeated over years. You cannot achieve them, you know, just by being uh, you know, uh strict about something for one month or maybe two months. Eventually, you know, they are finite, will uh and and you lose them. So I think that's really what intentional medicine is all about. It's about creating architecture for the health that supports you, not just for the today, but for decades to come.

Absolutely, no, and I I love the way that you said that, and I think that this is such a good conversation about the intentional, being intentional. And I think that today's conversation is a reminder that most sophisticated health strategy in the world still rests on the same three things how you sleep, how you move, and how stable your metabolism is. Because advanced tools don't help replace the foundation and they really only work when the foundation is already there. So I think that this was such an important reminder for all of us to really hear and really take a second to reset and have that thought process around it. And for those listening, make sure that you subscribe, follow, and join us as we continue building a more intentional approach to health, one layer at a time. It was nice speaking with you, Dr. Singh. It's always a pleasure. Um, before we wrap up, is there anything else you wanted to add at all?

No, I think this you you summarized it very well, Lella, that this is all in you know, intentional medicine is about. Foundation first, measure what matters, precise intelligently, and regenerate with the responsibility. So as we talk about the foundation, always comes first.

Absolutely. This is another great episode of Intentional Medicine. Thank you so much, Dr. Singh, and I can't wait to speak to you again soon. Have a good one. Likewise. Thank you so much, Leila.