June 21, 2022

Metabolic disease

How metabolic health impacts your ‘optimal’ diet

Read Time 2 minutes

This audio clip is from “Ask Me Anything” (AMA) episode #36 — all things fruits and vegetables, originally released on June 20, 2022.

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Show Notes

How one’s current state of health impacts their “optimal” diet [11:30]

  • Don’t confuse the optimal diet for you in a state of health versus the optimal diet for you in a state of sickness that’s trying to restore your health
  • For example: When Peter works with patients who are metabolically healthy, he’s never once restricted the amount of fruit they consume
    • But when working with a patient who has type 2 diabetes and non-alcoholic fatty liver disease, he will actually restrict how much fruit they consume
    • Peter says that “we’re going to have a better chance of improving your metabolic health if we at least temporarily reduce the volume of that significantly. Reduce the burden of fructose on your liver.”
    • This is because both fructose and ethanol are pretty uniquely poised to make a sick liver sicker
    • Does that mean that that person’s going to always be restricting fruit? ⇒ No, not necessarily, but empirically, it seems easier in those people to reduce fructose intake and to do so through fruits
  • Even for Peter personally, he says that how he eats today to preserve his health is “unquestionably different from how I was eating 15 years ago when I was in the process of trying to improve my health from a place that was actually below where it is today

Defining “metabolic health” [14:45]

There’s a lot of different ways you can define it

  • It’s sort of like BMI is the easiest way to to define overweight and obesity but body composition would be a better way to do it
  • Similarly, the quickest and easiest way to define metabolic health is probably to use the criteria for metabolic syndrome
    • metabolic syndrome is basically defined in a binary fashion where if you have three or more of the the following five criteria you are considered to have MetSyn:
      • Increased blood glucose
      • Abdominal (truncal) obesity
      • High fasting triglycerides
      • Low HDL cholesterol
      • High blood pressure
  • That said, Peter doesn’t use this with his patients since he’s not trying to make assessments at a population base level
  • He’s looking at many more factors beyond those things, such as:
    • oral glucose tolerance tests
    • uric acid levels
    • homocysteine levels
    • the entire lipid profile 
    • Functional testing
      • how the mitochondria perform in a zone two test
      • how much lactate is a person producing at rest and then how much lactate did they produce under increasing amounts of workload
§

health food with sport accessories

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