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Metabolic disease

One way to think about metabolic disease is as a disorder in fuel processing. Whether we’re talking about hyperinsulinemia or type 2 diabetes, the fundamental problem is that the body is not doing a good job storing and accessing fuel.

I think of the three most deadly chronic diseases — heart disease, cancer, and dementia — as pillars all resting on the foundation of metabolic disease. While complications from metabolic disease often do not directly lead to death, the indirect cost is staggering. Each of the other major pillars of chronic disease is exacerbated and amplified by metabolic dysregulation.

Metabolic disease typically exists on a continuum — progressing from hyperinsulinemia, to insulin resistance, to non-alcoholic fatty liver disease, all the way to type 2 diabetes — and tends to cluster with five signs which make up the diagnostic criteria for Metabolic Syndrome, including: high blood pressure, elevated triglycerides, elevated blood glucose, truncal obesity, and low HDL-cholesterol.

The following is a collection of content that dives deeper into the topic of metabolic health, discussing specific strategies for prevention and treatment.

Qualys #166 – Theories on the origins and evolutionary reasons for insulin resistance

This episode of The Qualys is from podcast #69 — Ronesh Sinha, M.D.: Insights into the manifestation of metabolic disease — which was originally released on September 2, 2019.

Qualys #261 – Insulin: The amazing story of its discovery, its effect on cellular metabolism and IGF-1, and why it’s so expensive

This episode of The Qualys is from podcast #69 — Jake Kushner, M.D.: How to thrive with type 1 diabetes and how everyone can benefit from the valuable insights — which was originally released on February 18, 2019.

Qualys #165 – Attempting to define insulin resistance with Nir Barzilai, M.D.

This episode of The Qualys is from podcast #33 — Nir Barzilai, M.D.: How to tame aging — which was originally released on January 7, 2019.

Qualys #101 – What the hell does insulin resistance actually mean?

This episode of The Qualys is from podcast #33 — Rudy Leibel, M.D.: Finding the obesity gene and discovering leptin — which was originally released on December 17, 2018.

Peter Attia on How Insulin Resistance Manifests in the Muscle

“If you’re in the business of wanting to live the healthiest life you can live, which means longer and better, you’ve got to be insulin sensitive, full stop.” — Peter Attia

#194 – How fructose drives metabolic disease | Rick Johnson, M.D.

“Fructose turns out to have been meant to be this wonderful system for survival, but in our culture with the amount of sugar in foods that we are eating (that either provide sugar or can be turned into fructose), this pathway has become hazardous.” —Rick Johnson

#173 – AMA #26: Continuous glucose monitors, zone 2 training, and a framework for interventions

“Zone two is a metabolic state. It’s not determined by speed. It’s determined by which energy system you’re requiring and what the equilibrium is.” —Peter Attia

#165 – AMA #24: Deep dive into blood glucose: why it matters, important metrics to track, and superior insights from a CGM

“Hyperinsulinemia on an [oral glucose tolerance test], even in the presence of normoglycemia, is the canary in the coal mine.” —Peter Attia

#162 – Sarah Hallberg, D.O., M.S.: Challenging the status quo of treating metabolic disease, and a personal journey through a grim cancer diagnosis

“For a disease that everyone thought was chronic and progressive, to see people recover from it is quite astounding.” —Sarah Hallberg

Does NMN improve metabolic health in humans?

Thoughts on the first efficacy trial recently published

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