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In this “Ask Me Anything” (AMA) episode, Peter dives deep into the critical topic of metabolic disease. He first sheds light on how poor metabolic health drives up the risk of developing other chronic diseases such as cardiovascular disease, cancer, neurodegenerative disease, and overall mortality. He explores the array of metrics and tests used to assess metabolic health, underscoring his preferred methodologies utilized with patients. Finally, Peter provides an overview of the factors one can manipulate in order to improve metabolic health.

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We discuss:

• Importance of metabolic health and a primer on metabolic disease [1:30];
• How poor metabolic health increases one’s risk for other chronic diseases [6:00];
• How useful is body weight and BMI for estimating metabolic health? [9:45];
• Overview of various tests and metrics used to understand metabolic health [12:15];
• Traditional biomarkers and how Peter’s point of view may differ from the guidelines [15:00];
• Lactate: insights into metabolic health through fasting and resting lactate levels [17:00];
• Zone 2 output: an important functional test of metabolic health [20:00];
• Cardiopulmonary exercise testing (CPET) [25:45];
• Visceral adipose tissue (VAT): what is VAT and how does it impact health? [27:00];
• Oral glucose tolerance test (OGTT): how it works and why it is such an important metric for assessing metabolic health [32:15];
• The utility of a continuous glucose monitor (CGM) [40:45];
• Liver function and NAFLD [42:15];
• Sleep as an intervention [46:00];
• Exercise as an intervention [53:15];
• Diet and nutrition [59:00];
• How reducing stress can improve metabolic health [1:05:15]; and
• More.

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