Episode 2: Metabolic Health w/ Dr. William Cromwell, M.D.

Show notes:

1:00 About Dr. William Cromwell (LinkedIn, Twitter).

7:00 Defining metabolic health and the relationship with cardiovascular disease and type 2 diabetes.

8:55 Insulin resistance (IR), Dr. Gerald Reaven (wikipedia, research) and the terminology around insulin resistance syndrome vs. metabolic syndrome; insulin resistance as the root cause of metabolic syndrome.

11:05 The physiology of insulin and "what happens when insulin is resistant”; effects (e.g. abdominal fat); IR as it relates to blood glucose; glucose’s important role in the body.

13:30 The benefits of continuous glucose monitors (CGM).

15:15 Defining type 2 diabetes and predicting diabetes. Is fasting glucose at 125 mg/dL a magic number?

17:40 Pre-diabetes (fasting glucose 100-125 mg/dL) is the American Diabetes Association (ADA) definition (link). What is the role of measuring insulin resistance during this period to reverse course before the onset of diabetes. The precipitous transition from pre-diabetes to becoming diabetic.

20:00 Predicting individual risk from developing diabetes. Why using Multi-Ethnic Study of Atherosclerosis (MESA) (link) to predict diabetic progression is important. The wide variance in diabetic risk at any given fasting glucose level

22:15 Why Precision Health Reports uses the nuclear magnetic resonance (NMR) lipoprofile insulin resistance (LP-IR) score (link). Although the ratio of triglycerides to HDL cholesterol is a way as well as HOMA-IR (link), LP-IR is uniquely able to independently predict future diabetic risk.

27:00 Why an accurate LP-IR score is important. The detrimental life impacts of type 2 diabetes.

29:00 Categorizing all aspects of metabolic syndrome and the Metabolic Syndrome Severity Score (link).

36:30 What to look for in your own metabolic health. Most actionable biomarker values to measure other than insulin resistance): lipoproteins (link).

41:30 Trusting the data. The benefits of refocusing on insulin resistance and taking a wholistic approach to make a lifelong healthy experience.

48:00 Covid-19 and poor metabolic health. What to know.

51:00 Other thought leaders in cardiometabolic health and resources: Dr. Peter Attia & Robb Wolf. The Healthy Rebellion.

53:00 Dr. Cromwell’s own dietary practices and advice about being okay with feasting for special occasions.

56:00 Thoughts on “low carb” and intermittent fasting.