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4.4. The Fourth Horseman: Metabolic Disease

In this video, we dive deeply into the last of the Four Horsemen of Longevity™: metabolic disease. As with the previous horsemen, we will begin with a baseline understanding of how this disease process develops and what this disease process does to your body. The bad news is metabolic dysfunction is extremely common in the modern world. The good news is you can almost be guaranteed to avoid it if you use the right tools and are committed to improving your metabolic health.
Additional Resources
Dive Deeper
The importance of metabolic syndrome and the man behind it
How deadly is type 2 diabetes?
Explaining the format of this AMA: Extracting insights from Gerald Shulman’s masterclass on insulin resistance | AMA #20 – Peter Attia
The basics of insulin, defining insulin resistance (IR), and gold-standard methods of quantifying IR in the muscle | AMA #20 – Peter Attia
Practical ways to test for insulin resistance in a normal clinical setting | AMA #20 – Peter Attia
How insulin resistance manifests in the muscle | AMA #20 – Peter Attia
The biochemical block in glycogen synthesis—drivers and mechanisms resulting in insulin resistance in the muscle | AMA #20 – Peter Attia
The disparity in fat oxidation between insulin-sensitive and insulin-resistant individuals | AMA #20 – Peter Attia
The fate of the ingested carbohydrate in someone who is insulin resistant | AMA #20 – Peter Attia
The prevalence and clinical phenotype of insulin resistance | AMA #20 – Peter Attia
The role of exercise in mitigating and reversing insulin resistance | AMA #20 – Peter Attia
How insulin resistance manifests in the liver | AMA #20 – Peter Attia
Biggest takeaways: what we can do to mitigate and prevent insulin resistance | AMA #20 – Peter Attia
Importance of metabolic health and a primer on metabolic disease | AMA #51 – Peter Attia
How poor metabolic health increases one’s risk for other chronic diseases | AMA #51 – Peter Attia
How useful is body weight and BMI for estimating metabolic health? | AMA #51 – Peter Attia
Overview of various tests and metrics used to understand metabolic health | AMA #51 – Peter Attia
Traditional biomarkers and how Peter’s point of view may differ from the guidelines | AMA #51 – Peter Attia
Lactate: insights into metabolic health through fasting and resting lactate levels | AMA #51 – Peter Attia
Zone 2 output: an important functional test of metabolic health | AMA #51 – Peter Attia
Cardiopulmonary exercise testing (CPET) | AMA #51 – Peter Attia
Visceral adipose tissue (VAT): what is VAT and how does it impact health? | AMA #51 – Peter Attia
Oral glucose tolerance test (OGTT): how it works and why it is such an important metric for assessing metabolic health | AMA #51 – Peter Attia
The utility of a continuous glucose monitor (CGM) | AMA #51 – Peter Attia
Liver function and NAFLD | AMA #51 – Peter Attia
Sleep as an intervention | AMA #51 – Peter Attia
Exercise as an intervention | AMA #51 – Peter Attia
Diet and nutrition | AMA #51 – Peter Attia
How reducing stress can improve metabolic health | AMA #51 – Peter Attia
How metabolic health impacts your ‘optimal’ diet | AMA #36 – Peter Attia
A masterclass on insulin resistance—molecular mechanisms and clinical implications | Ep. #140 – Gerald Shulman, M.D., Ph.D.
Finding the obesity gene and discovering leptin | Ep. #33 – Rudy Leibel, M.D.
Metabolic Effects of Fructose | Ep. #87 – Rick Johnson, M.D.
How fructose drives metabolic disease | Ep. #194 – Rick Johnson, M.D.
Insights into the manifestation of metabolic disease in a patient population predisposed to metabolic syndrome, and what it teaches us more broadly | Ep. #69 – Ronesh Sinha, M.D.