<p><a href="https://peterattiamd.com/ama51/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230918-pod-ama51&utm_content=230918-pod-ama51-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230918-pod-ama51&utm_content=230918-pod-ama51-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230918-pod-ama51&utm_content=230918-pod-ama51-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>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.</p> <p>If you're not a subscriber and are listening on a podcast player, you'll only be able to hear a preview of the AMA. If you're a subscriber, you can now listen to this full episode on your <a href="https://peterattiamd.com/members/private-podcast-feed/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230918-pod-ama51&utm_content=230918-pod-ama51-podfeed">private RSS feed </a>or our website at the <a href="http://peterattiamd.com/ama51/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=230918-pod-ama51&utm_content=230918-pod-ama51-podfeed">AMA #51 show notes page</a>. If you are not a subscriber, you can learn more about the subscriber benefits <a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=%20230918-pod-ama51&utm_content=230918-pod-ama51-podfeed">here</a>.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>Importance of metabolic health and a primer on metabolic disease [1:30];</li> <li>How poor metabolic health increases one's risk for other chronic diseases [6:00];</li> <li>How useful is body weight and BMI for estimating metabolic health? [9:45];</li> <li>Overview of various tests and metrics used to understand metabolic health [12:15];</li> <li>Traditional biomarkers and how Peter's point of view may differ from the guidelines [15:00];</li> <li>Lactate: insights into metabolic health through fasting and resting lactate levels [17:00];</li> <li>Zone 2 output: an important functional test of metabolic health [20:00];</li> <li>Cardiopulmonary exercise testing (CPET) [25:45];</li> <li>Visceral adipose tissue (VAT): what is VAT and how does it impact health? [27:00];</li> <li>Oral glucose tolerance test (OGTT): how it works and why it is such an important metric for assessing metabolic health [32:15];</li> <li>The utility of a continuous glucose monitor (CGM) [40:45];</li> <li>Liver function and NAFLD [42:15];</li> <li>Sleep as an intervention [46:00];</li> <li>Exercise as an intervention [53:15];</li> <li>Diet and nutrition [59:00];</li> <li>How reducing stress can improve metabolic health [1:05:15]; and</li> <li>More.</li> </ul> <p>Connect With Peter on <a href="https://twitter.com/PeterAttiaMD">Twitter</a>, <a href="https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>
Actionable Insights
Regularly assess the five signs of metabolic syndrome—truncal obesity (waist circumference >40 inches men, >35 inches women), elevated triglycerides (>150 mg/dL), depressed HDL (<40 mg/dL men, <50 mg/dL women), elevated blood pressure (>130/85 mmHg or on medication), and elevated fasting glucose (>100 mg/dL)—and their specific thresholds, aiming to have none of these risk factors for optimal health.
2. Prioritize DEXA Scans
Opt for DEXA scans to measure visceral adipose tissue, muscle mass, and overall body fat, as this provides a more accurate and relevant assessment of metabolic health compared to the crude tools of body weight and BMI.
3. Monitor Advanced Blood Biomarkers
Beyond standard annual physicals, track a comprehensive set of blood-based biomarkers including uric acid, homocysteine, insulin, hemoglobin A1c, liver function tests, and resting/fasting lactate levels to gain a nuanced understanding of individual metabolic health.
Utilize advanced functional tests such as zone two output, CPET testing (for oxygen and CO2 utilization under stress), oral glucose tolerance tests, and continuous glucose monitoring to evaluate metabolic health dynamically and in response to physiological demands.
5. Assess Liver Health
Investigate liver health using ultrasound combined with blood tests and algorithms to determine fibrosis scores, which are crucial for understanding the prevalence and impact of fatty liver disease on overall metabolic health.
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