Category

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 diseasesheart 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.

#149 – AMA #20: Simplifying the complexities of insulin resistance: how it’s measured, how it manifests in the muscle and liver, and what we can do about it

“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

#140 – Gerald Shulman, M.D., Ph.D.: A masterclass on insulin resistance—molecular mechanisms and clinical implications

“If we can understand insulin resistance, then that’s going to be the best way to fix diabetes, heart disease,. . .fatty liver disease, and slow down cancers.” — Gerald Shulman

#136 – AMA #17: Body composition methods tour de force, insulin resistance, and Topo Chico

“Skeletal muscles are the greatest reservoir that you have for glucose disposal.” —Peter Attia

#124 – AMA #15: Real-world case studies—metabolic dysregulation, low testosterone, menopause, and more

As a follow up to AMA #14 where Peter explained his framework for analyzing labs, this “Ask Me Anything” (AMA)…

#110 – Lew Cantley, Ph.D.: Cancer metabolism, cancer therapies, and the discovery of PI3K

“If I get a result that suddenly doesn’t make sense, to me that’s more exciting. . .if you figure out why it didn’t work and what was wrong, then that’s where most breakthroughs come from.” — Lew Cantley

#87 – Rick Johnson, M.D.: Metabolic Effects of Fructose

“Fructose turns out to be used by animals as a mechanism to store fat.” — Rick Johnson

#85 – Iñigo San Millán, Ph.D.: Zone 2 Training and Metabolic Health

“What I have been seeing for 25 years, working with elite athletes, is that [zone 2] is the exercise intensity where I see the biggest improvement in fat burning and the biggest improvement in lactic clearance capacity. Therefore, that means that the mitochondria is where you see the biggest improvement.” —Iñigo  San Millán, Ph.D.

#69 – Ronesh Sinha, M.D.: Insights into the manifestation of metabolic disease in a patient population predisposed to metabolic syndrome, and what it teaches us more broadly

“The way we raise our kids early on might actually set a pattern for how much of an accelerated life, or how much of a stressed out nervous system they might have later on. . . a lot of the behavioral patterns that we’re instilling in our kids are kind of setting the foundation for insulin resistance and inflammation early on.” —Ronesh Sinha

#66 – Vamsi Mootha, M.D.: Aging, type 2 diabetes, cancer, Alzheimer’s disease, and Parkinson’s disease – do all roads lead to mitochondria?

“We have 300 different forms of monogenic mitochondrial diseases. . .and these are terrible diseases and we need therapies for them. . .but it’s also our hope that studying some of them will provide insights into the common form of aging as well.” —Vamsi Mootha

#63 – AMA #7: Exercise framework, deadlifting, lower back pain, blood pressure, nootropics, CGM, and more

“The single greatest risk to my longevity is my lower back.” —Peter Attia

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