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What happens to nutrition science after the study is published? Dr. Maya Maroto, EdD, MPH, RD, is Executive Director of the Coalition for Metabolic Health. A registered dietitian and certified ketogenic nutrition specialist, she has worked in academia, in nutrition policy and communications at the FDA and USDA, and on the food industry side at FoodMinds. Her own turn toward carbohydrate restriction began when a loved one with type 2 diabetes did not improve on the conventional advice she had been trained to give. In this episode she joins Victoria Field and Dom D'Agostino to explain how research actually reaches policy: what changed in the new Dietary Guidelines for Americans, including first-ever language that people with certain chronic diseases may benefit from a lower carbohydrate diet; why guideline changes can take years to reach school meals and hospital menus; how congressional report language directed NIH institutes toward research on metabolic interventions for diabetes, obesity, cardiovascular disease, Alzheimer's, Parkinson's, and serious mental illness; and why, in her experience, the economic cost of chronic disease is what opens doors with lawmakers. The conversation also covers keeping metabolic health bipartisan, how food industry messaging shapes what clinicians and consumers believe, why many dietitians remain cautious about ketogenic diets, what GLP-1 medications mean for nutrition-first approaches, whether carbohydrate restriction is affordable on a SNAP budget, and what metabolic psychiatry needs to move from promising science to rigorous research. Questions Answered in This Episode: What actually changed in the new Dietary Guidelines, and why does the low-carbohydrate language matter?How long does it take for guideline changes to reach school lunches and hospital menus?How does congressional report language turn into NIH research funding?What persuades policymakers most: clinical data, patient stories, or the cost of chronic disease?Why are many dietitians cautious about ketogenic diets?Is therapeutic carbohydrate restriction too expensive for the people who need it most?Listeners and viewers will come away with a clearer picture of the machinery between metabolic science and the policies that shape what Americans eat, and where clinicians, researchers, and patients can push it forward. Special thanks to the sponsors of this episode: ✅ Genova Connect: Get 15% off any Genova Connect test kit with code METABOLICLINK here. ✅ iRestore: Shop the new Laser Face Mask Pro with code LINK here. More Links Coalition for Metabolic Health: coalitionformetabolichealth.orgJoin the Coalition's community and newsletter: coalitionformetabolichealth.org/join-our-communityContact the Coalition: [email protected] Group: baszuckigroup.comMetabolic Mind: www.metabolicmind.orgIn 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:  InstagramFacebookYouTubeLinkedInPlease 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 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: Why can a high VO2 max be misleading when muscle mass is low?How does Biograph turn dozens of diagnostics into one personalized plan?Why might fatty liver disease be harder to detect in women?How can whole-body MRI programs reduce false positives and unnecessary follow-up testing?What is proteomic "organ age," and can lifestyle change it?How should people on GLP-1 medications protect lean mass?Can preventive medicine become accessible beyond concierge care?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 Biograph: biograph.comBiograph x Vero organ age study: biograph.com/blog/organ-age-studyThe Metabolic Initiative (expert lectures, CME, ad-free episodes, live Q&As; first 7 days free): membership.metabolicinitiative.comIn 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:  InstagramFacebookYouTubeLinkedInPlease 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: What has Dr. Boz observed during her 72-hour sardine challenges?What did Dr. Boz observe when using low-dose tirzepatide in patients already in ketosis?What does "relief, not joy" reveal about carbohydrate addiction?Why can blood pressure medications require reassessment when starting a ketogenic diet?Why does she emphasize physician involvement when participants take prescription medications?Why does she combine group coaching with glucose and ketone tracking?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 Live Q&A with Dr. Boz, October 14, 9:00 AM PT / 12:00 PM ET (free, no membership): register hereDr. Boz's website: bozmd.comDr. Boz on YouTube: @DoctorBozDr. Boz's books: ANYWAY YOU CAN and ketoCONTINUUMThe Metabolic Initiative (expert lectures, CME, ad-free episodes, live Q&As; first 7 days free): membership.metabolicinitiative.comIn 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:  InstagramFacebookYouTubeLinkedInPlease 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: Why are uterine fibroids being reframed as cardiovascular disease of the uterus?Can the menstrual cycle function as a metabolic vital sign?How does insulin, acting as a stress hormone, shut down ovulation?Is there an optimal fasting insulin for reproductive health, and does body type change the answer?What does the shift from PCOS to PMOS change for diagnosis and treatment?What happens to insulin resistance in perimenopause, and was the Women's Health Initiative misread?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 Live Q&A with Dr. Salcedo, September 10, 9:00 AM PT (free): register hereDr. Salcedo's website: consciousgynecology.comDr. Salcedo on YouTube: @consciousgynecologistDr. Salcedo on Instagram: @consciousgynecologistPaper: The uterus is an end organ: a preliminary study of the association between abnormal uterine bleeding and hyperinsulinemia (Menopause, 2025)Paper: Therapeutic Carbohydrate Restriction as a Metabolic Modality for the Prevention and Treatment of Abnormal Uterine Bleeding (Nutrients, 2023)Dr. Salcedo is speaking on chronic stress, adversity, and gynecologic health at the Ketogenic Foundation conferenceThe Metabolic Initiative (expert lectures, CME, ad-free episodes, live Q&As; first 7 days free): membership.metabolicinitiative.comIn 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:  InstagramFacebookYouTubeLinkedInPlease 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: The muscle loss debate around GLP-1s has become polarized. Should clinicians be worried about muscle loss, muscle function, or neither?If you were diagnosed with cancer, are there any metabolic therapies you would start immediately?How long can it take for ceramides in adipose tissue to resolve — and insulin resistance to improve?Bioidentical D-BHB exogenous ketones are substantially more expensive. What is the value proposition over other forms?GLP-1 receptor agonists consistently raise resting heart rate. Is that something to be concerned about?Are there any emerging approaches to improving the management of type 1 diabetes?What happens metabolically, and to fat cells, glucose and ketones, when taking corticosteroids?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 Dr. Ben Bikman's website: benbikman.comInsulin IQ: insuliniq.comYouTube: youtube.com/@benbikmanInstagram: @benbikmanphdIn 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:  InstagramFacebookYouTubeLinkedInPlease 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:  InstagramFacebookYouTubeLinkedInPlease 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 Dr. Ben Bikman's website: benbikman.comInsulin IQ: insuliniq.comYouTube: youtube.com/@benbikmanInstagram: @benbikmanphdFeatured study: White Matter Lipids as a Ketogenic Fuel Supply in Aging Female Brain: Implications for Alzheimer's DiseaseIn 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:  InstagramFacebookYouTubeLinkedInPlease 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 What did 21 days of continuous glucose and ketone monitoring reveal during a ketogenic, 1,000-mile cycling journey?How did prolonged endurance exercise affect Dr. Lake’s daily insulin requirements?How is nutritional ketosis different from diabetic ketoacidosis, and what role does insufficient insulin play in DKA risk?What did Dr. Lake observe when his glucose and ketones began rising at the same time?How might fat adaptation influence fuel use and endurance performance?What are the practical limitations of continuous glucose and ketone monitoring for real-time insulin decisions?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: Shifting Gears, Dr. Lake’s book, on AmazonType1Keto, Dr. Lake’s site featuring the book and the Zero Five 100 projectSpecial 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:  InstagramFacebookYouTubeLinkedInPlease 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: For Richer, for Poorer: Low-Carb Diets Work for All IncomesOwnaHealth: Reverse the course of chronic disease — for everyone.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:  InstagramFacebookYouTubeLinkedInPlease 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: What hyperbaric protocol is best supported for treatment-resistant PTSD?What does a 35% reduction in CAPS score predict about long-term recovery?Which outcomes beyond symptom scores changed most for patients?How did the team build a hyperbaric sham that patients genuinely could not detect?Which safety measures are non-negotiable in a hyperbaric PTSD clinic?Does a patient's baseline metabolic fitness predict their response to HBOT, and can the treatment affect cardiometabolic risk?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:  InstagramFacebookYouTubeLinkedInPlease 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: InstagramFacebookX.comYoutubeLinkedInTikTokSpecial 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:  InstagramFacebookYouTubeLinkedInPlease 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.

In people with severe depression and cognitive decline, brain glucose metabolism has been shown in some studies to decline measurably. Ketone metabolism, by contrast, appears relatively preserved. That single observation is reshaping how researchers think about psychiatric illness. In this episode, Dominic D'Agostino sits down with Bret Scher, a cardiologist who pivoted to metabolic psychiatry and now leads clinical education and content for Metabolic Mind at the Baszucki Group. Dr. Scher brings a rare dual perspective: deep training in conventional cardiology paired with three years embedded in the research and clinical practice exploring metabolic approaches in psychiatry. The conversation covers brain energy dysfunction as a potential unifying mechanism across psychiatric disorders, the preserved ketone metabolism documented in work by researchers like Stephen Cunnane, the recently published Delphi consensus paper on metabolic psychiatry, why four-week randomized trials may be inadequate for nutritional interventions, and the case for future diagnostic categories like metabolic depression and metabolic bipolar disorder. Questions Answered in This Episode: Are we underestimating brain energy dysfunction as a potential unifying mechanism across psychiatric disorders?What are the two biggest clinical mistakes patients make when starting ketogenic therapy for mental illness?Should ketogenic therapy ever be positioned as a first-line intervention for psychiatric disorders?What is the single biggest bottleneck preventing wider clinical adoption of ketogenic therapy?What has been the most unexpected challenge in moving metabolic psychiatry into the mainstream?What does precision, personalized, prescriptive ketone metabolic therapy actually look like in clinical practice?This conversation reframes psychiatric illness as a question of brain energy alongside neurotransmitter signaling and other biological mechanisms, with implications for how the next decade of research and clinical training will unfold. Join the Live Q&A with Dr. Bret Scher. Bring your questions directly to Dr. Scher on May 29 at 10:00 a.m. Pacific / 1:00 p.m. Eastern. Register here. Where to Find Dr. Bret Scher Online: Metabolic Mind Coalition for Metabolic Health 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:  InstagramFacebookYouTubeLinkedInPlease 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.

A gene mutation that reduces ketone production in the fasted state is associated with sudden infant death in modern populations. But in the ancestral context where it evolved alongside an omega-3-rich diet, it may have been part of what kept infants alive. Dr. Gideon Mailer and Nicola Hale join The Metabolic Link to present their hypothesis that the CPT1A L479 Arctic variant is not anti-ketogenic but pro-metabolic flexibility, conserving glucose by upregulating ketosis at the fed-state threshold. Their work explains why SIDS rates are dramatically elevated in modern Inuit communities no longer eating the ancestral Inuit diet, and how omega-3 fatty acids counteract the downregulation the mutation produces. The clinical picture extends beyond infancy. Modern carriers of the variant show lower triglycerides, lower VLDL, slightly higher HDL, and a "healthy obesity" phenotype with favorable fat distribution. But the health advantages seen in traditional Inuit populations disappear with Western diet adoption, as cardiovascular disease and diabetes rates rise to match the general population. Questions Answered in This Episode: How is the mutation associated with SIDS, and why is there a detrimental effect in modern populations?How prevalent is the CPT1A Arctic variant in the U.S. population, and does partial Inuit ancestry carry metabolic consequences?How do omega-3 fatty acids physically upregulate CPT1A activity and concentration within cell membranes?What metabolic markers distinguish carriers of the L479 variant from non-carriers?What happens to cardiovascular disease rates in Inuit populations that adopt Western diets?What should people take away from the Arctic variant story for their own metabolic health?A sobering case study in what happens when ancestral genetic adaptations collide with modern dietary environments, and what can be recovered when they are realigned. 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:  InstagramFacebookYouTubeLinkedInPlease 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.

In a 12-week clinical trial at The Ohio State University, every woman with PCOS who completed the intervention experienced a change in her menstrual status. One participant, who had never had a period in her life, began menstruating within a week. Another saw spotting after five years of amenorrhea while taking only a ketone supplement without adopting a ketogenic diet. These are among the earliest controlled findings linking ketogenic interventions directly to reproductive hormone restoration. Dr. Madison Kackley is an Assistant Professor of Kinesiology at The Ohio State University and Director of the SHE Is Laboratory. Her work focuses on how hormonal fluctuations shape metabolic flexibility and resilience in women across the lifespan. In this episode, she explains why a single fasting glucose or insulin measurement is misleading without knowing where a woman is in her cycle, how the luteal phase creates a state of increased energy expenditure and insulin resistance that conventional carb-loading advice may worsen, and why perimenopausal women who jump into intermittent fasting and high-intensity exercise without prior fat adaptation can end up in a high-cortisol catabolic spiral. She also introduces the Renew study, which examines ketone supplementation alongside group exercise for postpartum depression, a condition she frames as an energy-availability problem rather than a purely psychological one. Questions Answered in This Episode: What will we look back on in ten years and realize we got fundamentally wrong about women's health?Why are women more susceptible to dementia than men, and what does it have to do with reproductive energy?Why might long-term hormonal birth control contribute to infertility, metabolic syndrome, and type 2 diabetes?Why can women in perimenopause feel exhausted and still not be able to sleep?Should weaning be understood as its own distinct hormonal event, separate from postpartum?For clinicians, researchers, and women navigating these transitions, this conversation previews the evidence-based framework that female metabolic health has been waiting for. 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:  InstagramFacebookYouTubeLinkedInPlease 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.

A veteran walks into the clinic with a persistent migraine. Four minutes of vagal nerve stimulation later, the migraine is gone. This is not a one-off result. It is what Dr. Michael Hoffman has been observing for over seven years in the VA hospital system, using non-invasive devices he considers severely underutilized. Dr. Hoffman is a stroke and cognitive-behavioral neurologist who trained at Columbia University, spent 14 years in the VA system, and has evaluated an estimated 10,000 stroke patients across his career. He now practices at the University of Central Florida, where he integrates ketogenic nutrition, advanced imaging, vagal nerve stimulation, and hyperbaric oxygen into his neurological care. In this episode, Dr. Hoffman walks through what he calls the "five brain fitness rules," the specific, measurable lifestyle prescriptions he gives every patient, and explains why standard cognitive screening tools like the MoCA and Mini Mental miss the most dramatic behavioral syndromes caused by brain injury. He also discusses why PET scans and diffusion tensor imaging should be used far more often, and why post-TBI hormonal evaluation is critical but routinely overlooked. Questions Answered in This Episode: What are the five brain fitness rules every neurological patient should follow?Why do standard cognitive tests fail to detect some of the most severe brain injury syndromes?How is vagal nerve stimulation treating migraines, and why is it so underutilized outside the VA?What clinical changes would most improve neurological care today?Does the evidence support hyperbaric oxygen therapy for traumatic brain injury?Could fungal infections contribute to some long-standing Alzheimer's diagnoses?What is the surprising decade when your brain's cognitive function peaks?Dr. Hoffman makes a case that the gap between what we know about the brain and what we do in clinical practice has never been wider, and that closing it starts with giving clinicians the time and tools to actually examine their patients. Learn more about Dr. Hoffman on his website here. Special thanks to the sponsors of this episode: ✅ Fatty15 – Get 15% off a 90-day Starter Kit with code METABOLICLINK here ✅ Troscriptions – Get 10% off your first order with code METABOLICLINK here ✅ ZocDoc - Find and instantly book a top-rated doctor 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:  InstagramFacebookYouTubeLinkedInPlease 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.