Most of us have a familiar relationship with health: we promise to eat better on Mondays, sign up for a gym membership every January, and convince ourselves that a few sleepless nights or skipped meals are no big deal. Until, of course, the body tells us otherwise. But cardiothoracic surgeon, Dr Shriram Nene believes we need to stop treating health as a repair job and start seeing it as a lifelong investment. After spending three decades as a heart surgeon, witnessing how lifestyle choices and delayed intervention can change the course of a person’s life, he is making a case for prevention over cure. At the Hyderabad launch of his book at Taj Krishna, 21 Days to Good Health, he speaks to CE about why 21 days are only the beginning, the health risks Indians often overlook, the importance of health span over simply living longer and why taking care of ourselves should never be a last-minute resolution.
Excerpts
Why did you choose 21 days?
The 21-day habit-formation concept is a myth that originated with plastic surgeon Dr Maxwell Maltz in the 1960s, after he observed that patients took about 21 days to recognise changes after surgery. Research suggests habits can take up to 66 days to become automatic, though this varies. The programme teaches health principles through five pillars. Nutrition accounts for 70–80 per cent of the equation. The second is movement, not just exercise. Walking for 15 minutes after each meal, traditionally known as shatapavali, adds up to 45 minutes daily, alongside cardio, strength and flexibility exercises.
The third is sleep, which supports memory, regeneration and well-being. A sleep sanctuary involves cooler temperatures, dim lighting and switching off devices an hour before bed. The fourth is stress and mindset, focusing on breathing, disconnecting, decompressing and treating mental health like any other medical condition. The fifth is community, connection and purpose. Loneliness affects longevity, while India’s traditionally close-knit communities offered protection against it. The programme champions health, happiness and prosperity, but without health the other two cannot be achieved. We need swasthata (well-being) before viksitata (development). The aim is to shift healthcare from acute treatment to prevention, early recognition and timely intervention.
From a medical perspective, what does resetting actually mean?
It means understanding your individual code; there is no universal manual for life. Personalised precision healthcare identifies what works for your body and lifestyle, from nutrition and exercise to sleep patterns. Resetting also means recognising that high-carbohydrate diets suited to an agrarian society may not suit people in sedentary jobs today, particularly when food is available at the press of a button. We must make sustainable changes suited to our present lifestyles. Genetics may predispose some people to heart disease, but identifying risks early can reduce complications.
What makes your approach different?
Unlike short-lived resolutions such as January gym memberships, the programme changes how people think about health and explains the science behind healthier choices. Its five pillars are easy to understand, practice and sustain. The body thrives on consistency, not fads; what works for one person may not work for another. The book is an easy, non-preachy read guiding readers without making them feel guilty when they stumble. It has three sections: the first 21 days, life after that and special cases. It champions Indian health and lifestyles rather than relying only on western models, with a dedicated chapter on women’s health and another on health issues men over 50 should watch for. My second book, To Infinity and Beyond, will explore longevity through an evidence-based approach. The aim is to help people build sustainable habits and create better lives together.
What were some of the myths that you particularly wanted to address?
India faces a growing risk of heart disease, partly because of ‘skinny fat’, where people may look healthy but have underlying risk factors. Indians have a genetic predisposition, often accompanied by high triglycerides and low-density lipoprotein (LDL) cholesterol. Stress, smoking, alcohol and increasingly energy-dense diets add to the risk. While genetic predispositions may not be alterable, high blood pressure, stress and obesity can be managed through early intervention. Diabetes is another major concern, and early recognition matters.
What have years of treating patients taught you about the difference between keeping someone alive and helping them lead a healthy, happy life?
As a heart surgeon, I can save lives, but cannot always restore health span because damage may have accumulated over 20 to 40 years. India faces three major healthcare gaps: lack of awareness, inadequate access to world-class, evidence-based care, and a disconnect between the business of medicine and patients that often makes treatment unaffordable. With only a small proportion of doctors serving rural communities, access remains a challenge.
We are exploring CSR-funded health education programmes for high school and college students, teaching fundamentals often missing from formal education. The book can also guide people of all ages in understanding and managing their health. With a young population, rising life expectancy and tremendous potential, India can transform its approach to healthcare. Ultimately, we must invest in health, well-being and one another to build better lives together.