Understanding and improving your metabolic health (AMA 51 Sneak Peek)

In this “Ask Me Anything” (AMA) episode, Peter dives deep into the critical topic of metabolic disease. He first sheds light on how poor metabolic health drives up the risk of developing other chronic diseases such as cardiovascular disease, cancer, neurodegenerative disease, and overall mortality. He explores the array of metrics and tests used to assess metabolic health, underscoring his preferred methodologies utilized with patients. Finally, Peter provides an overview of the factors one can manipulate in order to improve metabolic health.

We discuss:
00:00 - Intro
00:10 - Importance of metabolic health and a primer on metabolic disease
05:05 - How poor metabolic health increases one’s risk for other chronic diseases
09:39 - How useful is body weight and BMI for estimating metabolic health?
12:12 - Overview of various tests and metrics used to understand metabolic health
15:10 - Traditional biomarkers and how Peter’s point of view may differ from the guidelines

In the full episode, we also discuss:
-Lactate: insights into metabolic health through fasting and resting lactate levels;
-Zone 2 output: an important functional test of metabolic health;
-Cardiopulmonary exercise testing (CPET);
-Visceral adipose tissue (VAT): what is VAT and how does it impact health?;
-Oral glucose tolerance test (OGTT): how it works and why it is such an important metric for assessing metabolic health;
-The utility of a continuous glucose monitor (CGM);
-Liver function and NAFLD;
-Sleep as an intervention;
-Exercise as an intervention;
-Diet and nutrition;
-How reducing stress can improve metabolic health;and
-More.

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About:

The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 70 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more.

Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan.

Connect with Peter on:

Subscribe to The Drive:

[PeterAttiaMD]

In this sneak peek, we discuss:
00:00 - Intro
00:10 - Importance of metabolic health and a primer on metabolic disease
05:05 - How poor metabolic health increases one’s risk for other chronic diseases
09:39 - How useful is body weight and BMI for estimating metabolic health?
12:12 - Overview of various tests and metrics used to understand metabolic health
15:10 - Traditional biomarkers and how Peter’s point of view may differ from the guidelines

In the full episode, we also discuss:
-Lactate: insights into metabolic health through fasting and resting lactate levels;
-Zone 2 output: an important functional test of metabolic health;
-Cardiopulmonary exercise testing (CPET);
-Visceral adipose tissue (VAT): what is VAT and how does it impact health?;
-Oral glucose tolerance test (OGTT): how it works and why it is such an important metric for assessing metabolic health;
-The utility of a continuous glucose monitor (CGM);
-Liver function and NAFLD;
-Sleep as an intervention;
-Exercise as an intervention;
-Diet and nutrition;
-How reducing stress can improve metabolic health;
-Much more

[jrodartec]

Hey Peter, truly appreciate the format you designed for your premium / non-premium memberships. I believe it is absolutely fair - even generous - and also appealing. The information level and quality for "non-premium members" is great, so your can ensure the 80/20 impact for the largest share of your listeners (who probably wouldn't have their priorities or resources straight to become premium members). Thank you once again for teaching me so much, and asking so little from me in return. And also, for being a role-model in a range of dimensions, from more ethical (i.e., integrity, truth-seeking, honesty) to more technical (i.e., pragmatic thinking, structuring, communication) spheres. Hope all the best for you and for your community.

[ambition]

0:20: 📊 This AMA focuses on metabolic health and its impact on aging and disease.
4:29: 📊 The video discusses the definition of metabolic syndrome and its key components.
12:39: 💡 The speaker discusses the metrics used to understand metabolic health at an individual level, including functional tests, imaging tests, regular biomarkers, and special tests.
8:11: 🧠 Abdominal obesity may have a protective role in reducing the risk of Alzheimer's disease, but there is a higher risk for other forms of dementia.
16:01: 💡 The video discusses the benefits of becoming a premium member and the exclusive content and benefits offered.
Recap by Tammy AI

[robbatayaki]

I have a few health gurus. Pete is one of them

[AOL]

I love Ayrton Senna’s helmet in the background!

[Pustul]

I’ve listed to a lot of podcasts from Peter on this topic but the question of how to lower your apoB level non pharmacologically, especially when you are in your 30s and still have a chance of affecting it, is never approached. I know a ton on how cholesterol works and how it kills people but nothing on how to prevent it from killing me. It would be great to make an episode on that topic and related to that on how your diet affect your apoB level.

[channelguide]

Thank you for this valuable information.

[cindysmallwood]

Have listened for a while. Was an endurance athlete. Age65 and rampant arthritis. ( jt replacements looming ) can make a lot of his workout recs impossible for me. Wish there was more in between for the mere aging mortal

[EarthMan-hxxb]

What is the physical mechanism of fatigue? Like from sleep deprivation etc.

[coleenlewis-watts]

I don’t know if Dr. Attea answers questions but I am a 70-year-old woman with FHS muscular dystrophy. I had my hip replaced at 59 from my car accident. I fell on May 14 of this year just pre-my 70th birthday and dislocated my hip I subsequently had three more hip dislocations (spontaneously) I have had hip reconstruction. The down time was quite hard on my muscular dystrophy, but I am working hard to regain all my mobility. I’ve got a rebounder and have started exercising on it. I do seated yoga and strength training five days a week I don’t think I’m fooling myself, but I have not lost any mobility walking. I do use a cane or a walker, but I was pre-falling. Anyway is there anything that you know about as a physician that would help my muscular dystrophy. Significant muscle loss is in my shoulders and my hip girdle my leg seem to be hanging in there, thank you.

[cherylh]

Does anyone know if you get the numbers - the optimal readings for these bio markers - if you become a premium subscriber? And what that costs? Thanks in advance!🤗

[rfkyt]

It seems that American versus Canadian medical testing is a bit more broader and deeper. Never had my blood oxygen levels taken until going to the US during a typical examination. Maybe that's due to cost cutting, controlling the amount of time?

[Dominique]

The best, even if he is an over achiever as he labeled himself, he is so authentic and true to himself and very honest with others. Very credible not only because he is an MD…

[kulkarniravi]

What a coincidence! Just yesterday I was reading Jerry Reaven's 1988 Banting lecture.

[randya]

It's just a shame the life insurance companies place more emphasis on BMI than true measures of health.

[linasuematsumoto]

Love to see Ayrton Senna helmet ❤ luv from Brazil

[OreMan]

Is that helmet in the background Senna's? 🤔

[lisatowe]

Really appreciate the guys like Attia and Huberman who cover this important material so well.
I also enjoy Barbara O’Neill and Sam Bailey for holistic natural health.
Sinclair Kenalley and others really take you into the liver health etc
You tube and platforms like it allow a lot of information making it easy for busy folks to still learn

[rdbm-uozt]

Six years ago, I sustained my first heart attack. During my catheterization, dye injected into my heart's vascular system revealed a remarkable absence of atherosclerosis except for just one spot: a 95% blockage mid-LA. The surgeon fixing my heart said he only saw this occasionally in young women and rarely in men who exercise maybe too hard. (When men have their first heart attack after 60, they almost always come to the realization that there's plaque all over the place.) It's called SCAD. It's more dangerous in that the affected artery can rip open like a zipper, unlike the usual circumstance where a blood clot forms over a solidly planted ruptured plaque. Therefore, a stent was inserted to open up the blockage (consisting of ripped up endothelial tissue and blood) and to seal the rip.
I had been on a statin for five years until it seemingly exacerbated another chronic condition, in addition to Syndrome X, that I have (MCAS: Mast Cell Activation Syndrome) during the winter of 2011. My abdominal scan revealed a hyperechoic liver and a proximal colon (caecum, ascending, and transverse) squirming like a worm lost on a hot sidewalk. My symptoms (intense RUQ and RLQ abdominal discomfort, slight POTS, brain fog, fatigue, and pruritis) slowly subsided for over a year after discontinuing the drug. Back to 2017: at the ER, the attending doctor told me that my lipid profile was "deranged", and he wanted me back on a statin. However, my family doctor and my cardiologist thought I'd probably be alright on Ezetimibe in lieu of my angiogram, HDL, bilirubin, and athletically competitive attitude without pushing things further. Also, my optometrist was very surprised when I told him that I was recovering from my first heart attack (my retinal scans revealed nothing except a nevus). Also, my morning wood is as hard as ever.
I still exercise regularly, get sufficient sleep, and eat a much more Mediterranean Diet (with under 40% carbs). In the twentieth century, my triglycerides got over 500 (my serum looked like chicken soup, not apple juice) on a "normal" Western Diet (with 60% to 70% carbs); they now straddle the fence (135 to 175 on average).
Finally, my Dad lived into his mid-nineties without diabetic complications even though his fasting glucose (144) was well within the diabetic range. He didn't exercise and continued eating the way most eat (i.e., a "normal" Western Diet).

[kathrynsloan]

As I sit here eating a bowl of popcorn