Metabolic Health Topic Guide
Metabolic dysfunction doesn’t occur suddenly. It develops gradually, often over years, as the body loses its ability to store and access fuel efficiently. The consequences are wide-ranging, increasing the risk for cardiovascular disease, cancer, and neurodegenerative disorders.
This guide brings together the most practical tools, metrics, and interventions to help you understand, measure, and improve your metabolic health. Exclusively available for premium members.
How to Assess
Effective management starts with accurate measurement. Learn which laboratory and imaging tests provide the clearest picture of metabolic health — glucose, insulin, lipids, visceral fat, and more — and how to interpret them in context rather than in isolation.
Metabolic health assessment toolkit
A clinical example of early intervention for insulin resistance
How an eye exam can be a window into metabolic illness
How useful is BMI for assessing metabolic health?
The problem with HbA1c
Continuous glucose monitoring for metabolic insight
OGTTs uncover early insulin dysfunction
Oral glucose tolerance test (OGTT)
Fasting lactate as early marker of metabolic dysfunction
Fasting and resting lactate
Liver function and NAFLD
Zone 2 output as an indicator of metabolic health
Peter's top 5 biomarkers (if he had to choose)
How to Manage
Improving metabolic health requires targeted action. This section outlines the most effective levers — nutrition, exercise, sleep, stress management, and, when appropriate, pharmacologic therapy — and how to apply them with precision. Small, sustained changes can produce measurable improvements in metabolic function over time.
Lifestyle & pharmacologic interventions for pre-diabetes and diabetes
Five interventions for glucose management
Triple therapy for treating diabetes
What matters most in preventing and reversing insulin resistance?
Pros & cons of GLP-1 weight loss drugs
Pharmacologic interventions for insulin resistance and type 2 diabetes
Metabolic benefits of exercise & muscle mass
Red light therapy’s impact on metabolic health
How to think about glucose & insulin management
Metabolic effects of alcohol
Dietary approaches for reversing metabolic dysfunction and disease
Is it necessary to restrict fruit for optimal metabolic health?
How exercise improves insulin sensitivity
Peter’s hypothesis on glucose
Nutrition's impact on longevity via metabolic health
Aim for lower and less frequent glucose peaks
Having the lowest average blood glucose possible
Ceiling for peak glucose following a meal
Benefits of moving or exercising after a meal
Sleep as an intervention
The utility of continuous glucose monitors (CGM)
Metformin vs. lifestyle interventions
Is sugar poison?
Pairing carbohydrate restriction with exercise
Principles of a well-balanced diet
The pros and cons of ketogenic diets
Impact on Disease
Metabolic dysfunction sits upstream of nearly every major chronic disease. Understanding how it contributes to cardiovascular disease, cancer, and dementia provides context for why metabolic health is the foundation of longevity.
The impact of insulin resistance on disease risk
Type 2 diabetes and Alzheimer's disease
Impact of poor metabolic health on chronic inflammation
How hyperinsulinemia drives ASCVD
How insulin resistance drives chronic disease
How nutrition & metabolic health impact brain health
Visceral fat and metabolic health
How insulin resistance and type 2 diabetes influence hypertension
Insulin resistance often evades diagnosis and drives chronic disease
Defining Metabolic Dysfunction
Metabolic disease exists on a continuum, from early hyperinsulinemia to insulin resistance, fatty liver, and type 2 diabetes. This section explains the underlying physiology and progression, highlighting the mechanisms that link impaired fuel processing to disease.
What is Insulin resistance?
Defining metabolic syndrome
What's causing the diabetes epidemic
Pathophysiology of insulin resistance & type 2 diabetes
What causes insulin resistance?
The role of insulin in the body
Understanding what insulin resistance is
Insulin resistance develops long before elevated fasting glucose shows up
Defining insulin resistance across tissues & phenotypes
A mechanistic discussion of what causes insulin resistance
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Full Podcast Episodes Related to Metabolic Health
AMA
Understanding and improving your metabolic health
AMA
New insights on GLP-1 agonists (Ozempic, Wegovy, Mounjaro)
Guest Episode
Confronting a metabolic epidemic: understanding liver health and how to prevent, diagnose, and manage MAFLD and liver disease
AMA
Deep dive into blood glucose: why it matters, important metrics to track, and superior insights from a CGM
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Challenging the status quo of treating metabolic disease, and a personal journey through a cancer diagnosis
AMA
Metabolic health & pharmacologic interventions: SGLT-2 inhibitors, metformin, GLP-1 agonists, and the impact of statins
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Insulin resistance masterclass: The full body impact of metabolic dysfunction and prevention, diagnosis, and treatment
Guest Episode
A masterclass on insulin resistance—molecular mechanisms and clinical implications
AMA
Simplifying the complexities of insulin resistance: how it's measured and what we can do about it
AMA
Continuous glucose monitors, zone 2 training, and a framework for interventions
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Zone 2 Training and Metabolic Health
AMA
Optimizing nutrition for health and longevity: myth of a “best” diet, complexities of nutrition science, and practical steps for building a sustainable diet
AMA
Preventing cognitive decline, nutrition myths, lowering blood glucose, apoB, and blood pressure, and more
AMA
Exercise: longevity-focused training, goal setting, improving deficiencies, managing emotional stress, and more
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