<p><a href="https://peterattiamd.com/qps2/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=240930-pod-qps2&utm_content=40930-pod-qps2-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=240930-pod-qps2&utm_content=240930-pod-qps2-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=240930-pod-qps2&utm_content=240930-pod-qps2-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>In this quarterly podcast summary (QPS) episode, Peter summarizes his biggest takeaways from the last three months of guest interviews on the podcast. Peter shares key insights from each episode, covering diverse topics such as liver health with Julia Wattacheril, heart rate variability with Joel Jamieson, artificial intelligence with Zak Kohane, klotho for brain health with Dena Dubal, and lactate and lactate metabolism with George Brooks. Additionally, Peter shares any personal behavioral adjustments or modifications to his patient care practices that have arisen from these engaging discussions.</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=240930-pod-qps2&utm_content=240930-pod-qps2-podfeed">private RSS feed </a>or our website at the <a href="http://peterattiamd.com/qps2/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=%2040930-pod-qps2&utm_content=%20240930-pod-qps2-podfeed">episode #319 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=240930-pod-qps2&utm_content=240930-pod-qps2-podfeed">here</a>.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>Overview of topics, and the positive feedback on the quarterly podcast summary format [2:00];</li> <li>Julia Wattacheril episode: liver health and disease [4:00];</li> <li>Noninvasive methods to diagnose liver conditions, and how to manage and improve liver health [16:00];</li> <li>Joel Jamieson episode: heart rate variability (HRV) for training and health [27:15];</li> <li>Practical tools for measuring HRV and how it informs training and recovery decisions [37:00];</li> <li>Zak Kohane episode: artificial intelligence and medicine [47:15];</li> <li>The current role of AI in medicine and how it could revolutionize medicine in the future [53:45];</li> <li>The limitations and concerns pertaining to AI [1:00:15];</li> <li>Dena Dubal episode: the potential benefits of klotho for brain health [1:05:00];</li> <li>Animal studies on klotho and brain health [1:11:00];</li> <li>Genetics-based variations in klotho levels in humans and their impact on cognition, disease risk, and longevity [1:14:15];</li> <li>Testing klotho levels, the significance of the KL-VS variant, the role of exercise in increasing klotho, and more [1:17:30];</li> <li>The potential of klotho as a treatment for cognitive decline and Alzheimer's disease [1:23:15];</li> <li>George Brooks episode: a new paradigm to think about lactate and lactate metabolism [1:27:45];</li> <li>The potential for lactate infusions to aid in brain recovery following a head injury [1:34:00];</li> <li>The relationship between lactate and cancer, and the impact of exercise on lactate levels and cancer risk [1:36:30]; 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
1. Reduce Body Fat, Improve Insulin Sensitivity
Address liver fat and fibrosis by reducing excess adipose tissue and improving insulin sensitivity, as these interventions elicit the most favorable response for liver health.
2. Eliminate Alcohol with Liver Disease
If you have modest liver steatosis or fibrosis, completely remove all alcohol from your diet, even if your current consumption is considered moderate, to avoid adding any additional insults to the liver.
3. Minimize Liquid Fructose for Liver Health
Minimize or avoid liquid fructose in your diet if you have MASLD/NAFLD, as it is considered an additional potential insult to the liver.
4. Get Hepatitis B Vaccination
Get vaccinated for Hepatitis B, especially if you are coming of age, as a vaccine is available to protect against this liver-damaging infection and its associated cancer risk.
5. Don’t Rely Solely on ALT/AST
Do not solely rely on elevated transaminases (ALT and AST) as your threshold for concern for liver disease, as waiting for these enzymes to rise might mean waiting too long for diagnosis, especially in adults.
6. Monitor Statin Liver Enzymes
If you are taking lipid-lowering drugs like statins, monitor your AST and ALT levels; a persistent increase of one and a half to twofold would justify investigation and likely stopping the drug.
7. Consider FibroScan for Liver Assessment
For a practical, non-invasive assessment of liver fat and fibrosis, consider using an ultrasound and vibration method like FibroScan, which is less expensive and more widely available than MRI technologies.
8. Be Mindful of Alcohol Ethanol Content
Be mindful of the actual ethanol content and typical pour sizes of alcoholic beverages you consume, as standard drink sizes are often underestimated (e.g., wine pours are typically larger than 5 ounces).
9. Understand Exercise’s Impact on AST/ALT
If you engage in significant exercise, expect your AST to be typically higher than your ALT (e.g., ALT in mid-high 20s, AST in low-mid 30s), which is a common pattern for active individuals and not necessarily a cause for concern.
10. Screen for Hepatitis C and B
Ensure you are screened for Hepatitis C and B, regardless of other liver workups, due to their significant risk for liver failure and hepatocellular carcinoma.