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What would an emergency physician tell his patients if he could have met them 20 years before their crisis?
Dr. Michael Doney, MD, MPH, MS, spent years as a board-certified emergency physician managing the acute consequences of chronic disease. Today he is Executive Medical Director of Biograph, a preventive health clinic that combines whole-body MRI, cardiovascular imaging, DEXA, VO2 max testing, movement analysis, blood work, and genetics with a team of physicians, registered dietitians, exercise physiologists, and sleep specialists.
In this episode he walks Dom D'Agostino through how that data turns into a plan: why a high relative VO2 max can mask low skeletal muscle mass, especially in women in their late 40s and 50s; why Biograph talks about body recomposition, fiber, protein, and carbohydrate quality instead of weight loss alone; and what an internal study of about 1,000 members suggested about fatty liver disease in women, who in that cohort showed MASLD at lower BMI and visceral fat levels than men, with higher insulin resistance and fewer liver enzyme abnormalities. He also takes on the main critique of whole-body MRI, explaining how a standardized reporting system, subspecialty radiologists, and clinical context brought Biograph's reported referral rate for follow-up testing to about 5.4%, compared with the roughly one-third figure often cited.
The conversation also covers AI in imaging and in personal health data, diffusion-weighted MRI, a new study with Vero Bioscience tracking proteomic organ age through lifestyle interventions, mental health screening, how Biograph supports members already on GLP-1 medications, and what it would take to make this kind of prevention broadly accessible.
Questions Answered in This Episode:
Listeners and viewers will come away with a clearer picture of what a comprehensive preventive assessment measures, where its limits are, and how the results translate into nutrition, exercise, and sleep interventions.
Special thanks to the sponsors of this episode:
✅ Genova Connect: Get 15% off any Genova Connect test kit with code METABOLICLINK here.
✅ Zocdoc: Find and instantly book a top-rated doctor here.
✅ fatty15: Get 15% off a 90-day starter kit with code METABOLICLINK here.
More Links
In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!
You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!
Find us on social:
Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.
Join us for a FREE live Q&A with Dr. Boz on October 14 at 9:00 AM PT / 12:00 PM ET and ask her your questions directly. No membership required. Register here.
What happens when an internist teaches ketogenic nutrition to 200 students at the same time and tracks every one of their glucose and ketone readings on shared dashboards?
Dr. Annette Bosworth, MD, known to her audience as Dr. Boz, is an internal medicine physician and the author of ANYWAY YOU CAN and ketoCONTINUUM. After leaving corporate medicine she rebuilt her practice around ketone metabolic therapy, first with her own patients and now through a live 21-day class where small groups of ten work with coaches who have done the diet themselves.
In this episode she walks Dom D'Agostino through what that model has taught her: why every student does a 72-hour sardine fast and the changes she has observed in morning glucose and ketone readings the day after, how she started a medically supervised group already in ketosis on 0.6 mg of tirzepatide once weekly (approximately one-quarter of the labeled 2.5 mg starting dose) and her report that roughly nine in ten stayed at that dose, and why she asks every participant to keep their own physician involved
The conversation also covers the six-week ketogenic trial she ran with her mother during a leukemia recurrence, why she treats carbohydrate cravings the way she treated addiction in her clinic, and the free weekly support groups that classes from her first cohort still attend.
Questions Answered in This Episode:
Listeners and viewers will come away with a practical picture of ketone metabolic therapy as it is actually delivered: the protocol, the monitoring, the medication monitoring and reassessment, and the community structure that keeps people in it.
Special thanks to the sponsors of this episode:
✅ Genova Connect: Get 15% off any Genova Connect test kit with code METABOLICLINK here.
✅ Cowboy Colostrum: Get up to 25% off your entire order with code METABOLIC here.
✅ iRestore: Get the iRestore Elite helmet and Illumina face mask bundle at an exclusive discount with code LINK here.
More Links
In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!
You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!
Find us on social:
Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.
Join us for a FREE live Q&A with Dr. Salcedo on September 10 at 9:00 AM PT / 12:00 PM ET and ask her your questions directly. Register here.
What if the uterus is an end organ, responding to insulin and inflammation the same way the heart, kidneys, and liver do?
Dr. Andréa Salcedo is a board-certified OBGYN (DO, MPH, FACOG) and associate professor at Loma Linda University School of Medicine whose research and clinical practice, which she calls conscious gynecology, examine gynecologic disease through a metabolic lens.
In this episode she walks through the evidence that uterine fibroids share progenitor cells with atherosclerotic plaque, why she now teaches residents that fibroids are cardiovascular disease of the uterus, and how high insulin acts at the level of the brain stem to block ovulation. The conversation also covers her clinical observations on fasting insulin thresholds by body type, the renaming of PCOS to PMOS, what hormonal contraceptives do and do not treat, the role of chronic stress and adversity in gynecologic disease, and the four insulin-resistant transitions of a woman's life.
Questions Answered in This Episode:
Viewers will come away with a physiological framework that treats heavy periods, fibroids, irregular cycles, and PCOS as early signals of metabolic dysfunction rather than isolated hormone problems.
Special thanks to the sponsors of this episode:
✅ Genova Connect: Get 15% off any Genova Connect test kit with code METABOLICLINK here.
✅ Cowboy Colostrum: Get 25% off your entire order with code METABOLIC here.
✅ Zocdoc: Find and instantly book a top-rated doctor here.
✅ fatty15: Get 15% off a 90-day starter kit with code METABOLICLINK here.
More Links
In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!
You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!
Find us on social:
Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.
Today we are doing something we have never done before.
Once a month, members of The Metabolic Initiative get an hour to put their own questions directly to the scientists and clinicians at the forefront of metabolic health. Those sessions stay inside the platform. This one does not.
After Dr. Ben Bikman joined us for episode 100, the questions kept coming. So we invited him back to sit with Dr. Dominic D'Agostino and MHI co-founder Victoria Field for a live member Q&A, and for the first time we are releasing the full session publicly.
What came out of it: GLP-1 medications and the muscle loss debate, and how Ben's own position on these drugs has shifted. Insulin resistance and ceramides. Exogenous ketones, and when they may actually be useful. Metabolic approaches to cancer and the glucose ketone index. Exercise timing. Type 1 diabetes. Cortisol and fat distribution. Supplements.
Questions Answered in This Episode:
This is the kind of conversation we host every month inside The Metabolic Initiative, alongside expert presentations from our conferences and a library built entirely around metabolic health and therapy, with CME credit available on eligible content for healthcare providers.
If you want to be in the room for the next one, the first seven days are free. membership.metabolicinitiative.com
Special thanks to the sponsors of this episode:
Genova Connect: Get 15% off any Genova Connect test kit with code METABOLICLINK here.
Cowboy Colostrum: Get up to 25% off with code METABOLIC here.
More Links
In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!
You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!
Find us on social:
Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.
Ketogenic and low-carbohydrate diets often focus on a specific carbohydrate target: keep your net carbs under 30 grams. But as registered dietitian and certified diabetes educator Franziska Spritzler demonstrates in this presentation from Metabolic Health Summit, a carbohydrate target is not a therapy. Effective implementation means a full assessment of medical history, medications, labs, food preferences, lifestyle, and the motivation that will carry a patient through year one and beyond.
Spritzler specializes in low-carbohydrate and ketogenic nutrition and has extensive experience helping people use these approaches to improve metabolic health. The creator of lowcarbdietitian.com, she walks through the practical decisions clinicians face: when a ketogenic diet is warranted versus a more flexible low-carbohydrate approach, why she recommends 1.2 to 1.8 grams of protein per kilogram rather than the RDA's 0.8, how to manage medication adjustments for patients at risk of hypoglycemia or hypotension, and how to handle electrolytes, carbohydrate counting, sweeteners, and plant-based variations without losing the patient along the way.
Questions Answered in This Episode:
• What actually separates a ketogenic diet from a low-carbohydrate diet, and when does the difference matter?
• Why is the protein RDA too low for long-term metabolic health, and what range does Spritzler recommend instead?
• Who should avoid ketogenic diets entirely, and why are most contraindications manageable with closer supervision?
• How should medications be monitored and adjusted when a patient begins carbohydrate restriction?
• Should patients count net carbs or total carbs, and why are packaged "net carb" labels unreliable?
• Can a ketogenic diet be done as a vegetarian or vegan?
A practice-tested blueprint for turning carbohydrate restriction from a prescription into a therapy patients can sustain.
Special thanks to the sponsors of this episode:
✅ Genova Connect: Get 15% off any Genova Connect test kit with code METABOLICLINK here.
✅ iRestore: Get a special discount on the iRestore Illumina Face Mask with code LINK here.
✅ fatty15: Get an additional 50% off a 90-day subscription starter kit with code METABOLICLINK.
✅ Zocdoc: Find and instantly book a top-rated doctor here.
More Links
• Franziska's website: lowcarbdietitian.com
• The Metabolic Initiative (expert lectures, CME, ad-free episodes, live Q&As; first 7 days free): membership.metabolicinitiative.com
In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!
You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!
In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!
You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!
Find us on social:
Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.
Join us for a live Q&A with Dr. Ben Bikman here.
For the 100th episode of The Metabolic Link, Ben Bikman, PhD, professor of cell biology and physiology at Brigham Young University and author of Why We Get Sick, returns for a milestone conversation with co-hosts Dominic D’Agostino, PhD, and Victoria Field. Together, they examine what clinicians are measuring, what conventional approaches may be missing, and how the science of metabolic health continues to evolve.
Bikman argues that the clinical picture of metabolic health remains glucose-centric and lipid-heavy while the earliest signal, elevated insulin, goes unmeasured. He explains why women stay insulin sensitive at far higher body fat than men and what menopause takes away, why visceral fat is misunderstood, and how a fatty liver can be miscounted as lean mass on a DEXA scan. That last point is why he now says he was wrong about GLP-1 drugs, and why he thinks they should be prescribed as something other than weight loss medication.
Questions Answered in This Episode:
• Why does standard bloodwork detect metabolic dysfunction so late?
• Why are women more insulin sensitive than men at the same or higher body fat?
• What actually changes metabolically during menopause?
• Is visceral fat inherently dangerous, or is something else going on?
• Why did Dr. Bikman change his position on GLP-1 medications?
• Should GLP-1 drugs be prescribed as weight loss drugs at all?
This milestone episode offers a rigorous, physiology-first look at where metabolic science stands today, and what researchers and clinicians may need to examine next.
Thank you for listening, watching, sharing these conversations, and helping us reach 100 episodes. We’re incredibly grateful to have you as part of this community.
Special thanks to the sponsors of this episode:
Genova Connect: Get 15% off any Genova Connect test kit with code METABOLICLINK here.
Cowboy Colostrum: Get up to 25% off with code METABOLIC here.
iRestore: Get a special discount on the iRestore Illumina face mask with code LINK here.
More Links
In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!
You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!
Find us on social:
Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.
What can 21 days of continuous glucose and ketone data, recorded during a 1,000-mile cycling journey, reveal about managing type 1 diabetes on a ketogenic diet?
Dr. Ian Lake is a UK-based primary care physician who has lived with type 1 diabetes for more than 30 years. After two decades of conventional high-carbohydrate management, he adopted a very low-carbohydrate, ketogenic approach and began examining insulin not simply as a glucose-lowering medication, but as a metabolic hormone whose requirements are influenced by nutrition, exercise, sleep, circadian rhythm, hydration, and stress. His new book, Shifting Gears, documents the ride and the lessons he took from it.
Dr. Lake treated the journey as a 21-day personal experiment, wearing continuous glucose and ketone monitors while consuming roughly 20 grams of carbohydrate per day. In this conversation with Dr. Dominic D’Agostino, he shares what his data showed: an average ketone level near 1.2 mmol/L, daily insulin requirements declining from the mid-20s of units to around 16, and an episode in which glucose and ketones rose together after he had taken too little insulin.
Dr. Lake describes how, in his case, one unit of insulin brought his ketones from approximately 3.0 to 0.9 mmol/L within about 20 minutes. He and Dr. D’Agostino use the experience to explore the distinction between nutritional ketosis and diabetic ketoacidosis, the essential role of adequate insulin, and why ketone readings must always be interpreted alongside glucose levels and clinical context.
They also discuss insulin sensitivity during prolonged exercise, the practical challenges of adjusting insulin during endurance activity, and research suggesting that fat-adapted athletes may sustain high rates of fat oxidation at relatively high exercise intensities.
Questions Answered in This Episode
This conversation offers a rare look at 21 consecutive days of glucose, ketone, insulin, nutrition, and exercise data, while also emphasizing that Dr. Lake’s experience is an individual case, not a substitute for personalized medical supervision.
More Links:
Special thanks to the sponsors of this episode:
✅ Zocdoc: Find and instantly book a top-rated doctor here.
✅ fatty15: Get an additional 50% off a 90-day subscription starter kit with code METABOLICLINK.
✅ Toups and Co: Get 25% off your first order with code METABOLIC.
In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!
You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!
Find us on social:
Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.
Attend a Live Q&A with Dr. Glandt. Reigster here.
What if the way we treat type 2 diabetes is fundamentally backwards?
Dr. Mariela Glandt is an endocrinologist and obesity medicine specialist who spent 15 years practicing conventional medicine before concluding, in her words, that how we treat diabetes “is actually upside down.” As co-founder of OwnaHealth, she focuses on addressing the insulin resistance underlying type 2 diabetes, not only the elevated blood sugar it eventually causes.
In this episode, she walks through the science of that shift: why fasting insulin may reveal metabolic dysfunction before A1C becomes abnormal, why a laboratory “normal” range running up to 20 can be misleading, and why she believes repeatedly escalating insulin can contribute to weight gain, reduced insulin responsiveness, and worsening metabolic health.
She also shares what she has learned bringing low-carbohydrate and ketogenic therapy to underserved communities in the South Bronx, where patients may be navigating severe diabetes alongside financial pressure, cultural food traditions, psychiatric illness, chronic stress, and conflicting medical advice. Her work shows that these therapies can succeed even in communities facing significant barriers to care.
Dr. Glandt also breaks down what GLP-1 medications actually do, where they can help, and what they may leave unresolved—including the risks of muscle loss, inadequate protein intake, and relying on medication without addressing the patient’s broader metabolic health.
Questions Answered in This Episode:
• What key mindset shifts do conventionally trained physicians need to make when transitioning to a more integrated approach to medicine?
• How does reframing diabetes as insulin resistance change the way a doctor practices?
• What are the earliest signs of metabolic dysfunction that many clinicians miss?
• Can ketogenic metabolic therapy succeed in underserved communities?
• What do GLP-1 medications actually solve, and what do they leave untouched?
• Where can ketogenic therapy and GLP-1 medications work together?
• What has Dr. Glandt observed in patients living with both metabolic and psychiatric illness?
• Where does endocrinology most need to change course?
Viewers will come away with a different lens on metabolic disease, one that looks beyond glucose and weight to the biological, social, and practical factors shaping a patient’s health.
More links:
Special thanks to the sponsors of this episode:
✅ Toups and Co – Get 15% off your first order with code METABOLIC here.
✅ iRestore – Get a huge discount on the Elite and the Illumina bundle with the code LINK here.
In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!
You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!
Find us on social:
Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.
Fewer than 40% of people with PTSD respond to standard care. For the intrusive symptoms at the core of the disorder, response rates may be lower than 15%. So what options remain for patients who have not responded to existing treatments?
Dr. Keren Doenyas-Barak, director of the PTSD program at the Sagol Center for Hyperbaric Medicine and Research and a faculty member at Tel Aviv University, has treated close to 1,000 civilian and military patients and led sham-controlled trials that are helping reshape how hyperbaric medicine is studied.
She walks host Dr. Dominic D'Agostino through the protocol her clinic uses—60 sessions over 12 weeks, with oxygen cycled at two atmospheres—the 35% CAPS-score improvement associated with continued progress after treatment ends, and the reported two-year outcomes, including improved occupational function, roughly double the proportion of patients living with a partner, and sharp drops in benzodiazepine and cannabis use. She also details the convincing sham control her team engineered after concluding that earlier placebo arms may have delivered a physiologically active dose.
Questions Answered in This Episode:
A rigorous, frontline examination of what responsible hyperbaric medicine actually requires, led by a clinician helping to build its evidence base.
Special thanks to the sponsors of this episode:
✅ Toups and Co – Get 15% off your first order with code METABOLIC here.
✅ iRestore – Get a huge discount on the Elite and the Illumina bundle with the code LINK here.
✅ MudWtr – Get up to 43% off + free shipping and a free rechargeable frother with code METABOLICLINK here.
In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!
You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!
Find us on social:
Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.
Dr. Paul Reynolds has spent his career studying what he calls “two heads of the same beast”: inflammation and glycation — two interlocking processes that may help explain why so many chronic diseases are connected, even when they are treated as separate conditions.
Dr. Reynolds is a professor and research scientist at Brigham Young University whose NIH-funded research program studies inflammation, lung biology, glycation, and the AGE/RAGE receptor system that links metabolic and environmental stressors to disease throughout the body.
In this episode, Dr. Reynolds traces the glycation cascade from early sugar-protein reactions to advanced glycation end-products, or AGEs, and explains how the RAGE receptor can act as a self-perpetuating accelerant for inflammation. He also breaks down why the brain may be uniquely vulnerable to glucose dysregulation, how diesel exhaust and tobacco smoke can create AGE-like structures that bind the same inflammatory receptors, and how the glyoxalase defense system helps neutralize damage before it becomes permanent.
Questions Answered in This Episode:
Can breathing polluted air trigger some of the same inflammatory pathways as excess sugar exposure?
Is browned food a real glycation concern, or is the bigger issue what happens inside the body when glucose stays elevated?
Why is the brain especially vulnerable to glucose dysregulation?
How does fasting help the body reduce glycation and inflammatory burden?
What do people need to understand about sugar substitutes like allulose and xylitol when it comes to glycation?
How should we approach kids’ nutrition if glycation and inflammation can begin early in life?
Is glycation damage reversible, and where does the body draw the line?
This conversation offers a mechanistic map connecting cardiovascular disease, neurodegeneration, metabolic dysfunction, environmental exposures, and visible aging back to two upstream processes many patients never hear named in a clinical visit.
Find the Meet Consumption and Cognitive Health paper here.
Sign up for his upcoming Q&A on The Metabolic Initiative here.
Find Dr. Reynolds online:
Special thanks to the sponsors of this episode:
✅ Toups and Co – Get 15% off your first order with code METABOLIC here.
✅ Fatty15 – Get 15% off a 90-day Starter Kit with code METABOLICLINK here
✅ ZocDoc - Find and instantly book a top-rated doctor here
In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!
You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!
Find us on social:
Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.
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