How metabolic health impacts your 'optimal' diet

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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”

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

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