#271 - AMA #51: Understanding and improving your metabolic health
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Sep 18, 2023
Dive into the critical world of metabolic health and its role in chronic diseases like heart issues and cancer. Explore why traditional metrics like BMI fall short and discover better ways to assess health. Learn about various tests and biomarkers, along with actionable tips to boost your metabolic wellness. This discussion demystifies metabolic syndrome, providing insights on how lifestyle changes can make a significant difference to overall health.
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Metabolic Syndrome Defined
Metabolic syndrome includes truncal obesity, elevated triglycerides, low HDL, high blood pressure, and high glucose.
Having even one of these factors increases the risk of chronic diseases.
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Metabolic Syndrome and Chronic Diseases
Metabolic syndrome significantly increases the risk of cardiovascular issues, various cancers, and neurodegenerative diseases like Parkinson's and Alzheimer's.
Obesity is the second largest environmental trigger for cancer, after smoking.
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BMI's Limitations
BMI is a crude tool at a population level but less useful for individual metabolic health assessments.
Peter Attia doesn't use BMI for his patients, favoring more detailed metrics like DEXA scans.
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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.
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We discuss:
Importance of metabolic health and a primer on metabolic disease [1:30];
How poor metabolic health increases one’s risk for other chronic diseases [6:00];
How useful is body weight and BMI for estimating metabolic health? [9:45];
Overview of various tests and metrics used to understand metabolic health [12:15];
Traditional biomarkers and how Peter’s point of view may differ from the guidelines [15:00];
Lactate: insights into metabolic health through fasting and resting lactate levels [17:00];
Zone 2 output: an important functional test of metabolic health [20:00];
Cardiopulmonary exercise testing (CPET) [25:45];
Visceral adipose tissue (VAT): what is VAT and how does it impact health? [27:00];
Oral glucose tolerance test (OGTT): how it works and why it is such an important metric for assessing metabolic health [32:15];
The utility of a continuous glucose monitor (CGM) [40:45];
Liver function and NAFLD [42:15];
Sleep as an intervention [46:00];
Exercise as an intervention [53:15];
Diet and nutrition [59:00];
How reducing stress can improve metabolic health [1:05:15]; and
The Peter Attia Drive