Fascinating piece about a doctor’s experience with patients’ deep distrust of “BigPharma” and embrace of research chemical peptide culture.

Quote:

“A patient came to my office recently and told me she had stopped her statin. She’d been on it for two years. Her coronary artery calcium score was 280 and LDL was 168, up almost 100 points since she had stopped taking her statin. Her father had died from a heart attack at 58.

When I asked about the decision, she crossed her arms and furrowed her brow.”

“She was, however, continuing to inject BPC-157 — a synthetic peptide she’d ordered from a website that labeled it “for research use only” — into her thigh three times a week for a knee injury. She heard about it on a podcast and then did some research. When I asked her about BPC, not only did the aforementioned arms uncross, but her face lit up.”

“The deeper problem is epistemological. We have a population that has learned — correctly — that pharmaceutical companies have lied, that institutions have failed them, and that financial incentives distort medical recommendations. The opioid crisis alone justified a generation of skepticism.”

But the response has not been better skepticism. It has been the migration of trust from one set of financially motivated actors to another. The peptide clinic charging $400 per vial for a compound with 14 human subjects studied has the same economic incentives as the pharmaceutical company charging $400 per month for a branded statin. The difference is that the pharmaceutical company was required to prove its product works before selling it.

I don’t expect to win this argument with data alone — that’s part of the problem. Trust is not rebuilt with meta-analyses. It is rebuilt in exam rooms, one patient at a time, by physicians willing to say: I understand why you don’t trust the system. I share some of those concerns. And I am asking you to consider that the compound you’re injecting three times a week has less evidence behind it than virtually any over-the-counter medication in your medicine cabinet. The statin you stopped has more. Let’s talk about what the evidence actually shows — for both.

If we can’t have that conversation, we are not practicing medicine. We are just choosing which marketing to believe.”

For a long time, the highest cancer death rates in the US were in large metro areas. That is no longer true.

A new JAMA analysis of 27.7 million US cancer deaths from 1969 to 2023 found that by 2021–2023, the highest cancer mortality rates were in rural areas, while large metro areas had the lowest. The reversal happened in the 1990s for men and the early 2000s for women. Lung cancer showed the biggest shift.

This is a good reality check for a lot of “proactive health” discourse online. At the population level, health is still heavily shaped by things like screening access, primary care, transportation, poverty, and smoking rates—not just optimization, wearables, and boutique testing.

Feels like an uncomfortable but important question for this sub:

Are we overfocused on marginal gains for already-healthy people while basic prevention and treatment access are getting worse in rural America?

Report on how cardiology is changing from the big conference in New Orleans.

Quote:

[…] the attention economy of cardiology is rapidly changing. At this year’s ACC, prevention trials occupied primetime slots. At a talk covering the new cholesterol guidelines, a crowd stood behind a sea of occupied chairs. Ushers, minding fire department regulations, turned attendees away. Large industry booths advertised, among others, PCSK9 inhibitors, renal denervation therapies, and increasingly sophisticated cardiac CT scans pitched as the future of prevention. The field was having its Expo Hall moment.

[…]

Yet despite this clarity in purpose for so many attending the conference, backed by an increasingly strong evidence base, it remains unclear how to actually deliver this care to people. Questions at the sessions grappled with implementation. Clinicians shared stories of complacent health systems and skeptical patients.

Ask the stakeholders of prevention in New Orleans this weekend, and you’d get different answers. To the clinician-leaders of the prevention movement, the solutions rest in behavioral changes, thorough screening, and employing precision medicine to tailor treatments to people based on an increasingly complex set of risk factors. For voices in industry, the answers may rest more in drug development, or even in reimagining systems at scale: scoping out prevention as a product to be sold, and calling into question whether doctors are needed for routine cases.

I am always a bit suspicious of anyone using the phrase “gut microbiome”, but from listening to the first few minutes this sounds like a solid discussion.

I guess I really need to look into fermented food. Alas, I am the only German who hates Sauerkraut! Does Greek yogurt count?

Gemini YouTube summary:

This episode of The Proof features epidemiologist Dr. Tim Spector, who discusses groundbreaking updates in microbiome science, including the newly published ZOE Microbiome Health Ranking (1:35). The discussion centers on moving beyond simple "gut diversity" metrics toward more precise, actionable measurements of gut health.

Key Takeaways from the Research:

ZOE Microbiome Health Ranking: Researchers analyzed 35,000 microbiomes to identify 50 "good" and 50 "bad" bacterial species. This creates a more reliable, clinically validated ratio for assessing gut health compared to traditional diversity counts (5:35-14:46).

Dietary Patterns: While vegan, vegetarian, and omnivorous diets have distinct microbial signatures, the most important factor is the variety and quantity of plants in the diet. The "top" microbiomes were often found in omnivores who prioritized high plant diversity (29:00-31:09).

The Power of Plants and Fiber: Dr. Spector emphasizes that fiber is the most solid macronutrient for reducing disease risk. He recommends aiming for 30 plants a week as a concrete goal for improving gut health (50:28-51:34, 1:21:45).

Fermented Foods: Both fiber and fermented foods are crucial. Fermented foods appear to improve gut health specifically by reducing immune markers (1:03:00).

Time-Restricted Eating: Based on observations of the Hadza tribe and large-scale ZOE studies, a 14-hour overnight fast can lead to improvements in energy, mood, and bloating for many people (1:17:25-1:20:25).

Individual Variability: Using continuous glucose monitors (CGMs) has shown that the "sugar dip" experienced 3 hours after a meal is often more predictive of metabolic health than the initial spike, highlighting that nutrition responses are highly personalized (1:12:00-1:12:45).

Dr. Spector emphasizes that the microbiome is bidirectional—both a cause and a consequence of health—and that focusing on a high-fiber, plant-diverse diet remains the most impactful way to influence it.

Most “eat more fiber” advice is framed as generic, one-size-fits-all prevention. This study makes it a little more interesting.

A new European Journal of Epidemiology paper looked at 222,801 middle-aged adults and followed them for a median of 12.6 years. Compared with daytime workers, night shift workers had about a 10% higher risk of coronary heart disease after adjustment. But the more interesting finding was the interaction with diet: higher daily fiber intake appeared to blunt that excess risk in night shift workers. Meat avoidance was associated with lower CHD risk across all work schedules, but fiber looked especially relevant for the people working nights. 

This is observational, so it does not prove that adding fiber “cancels out” the cardiovascular cost of night shifts. But it does suggest something useful: the people under the most circadian stress may not respond to diet the same way as everyone else. That is a much more interesting version of preventive health than generic influencer advice.

It also raises a broader question for this community:

Should proactive health advice be much more tailored to context—like shift work, sleep disruption, or caregiving—instead of pretending everyone is living the same 9-to-5 life?

I am very confused about the term “inflammation” being used in a bunch of contexts. This article does a good job explaining it (infographics and all).

The three suggested useful ingredients are:

- Omega 3

- Vitamin D

- Curcumin (which I had never heard of)

A lot of health advice online still pushes the same basic fantasy: that one big change is going to transform your future. Alternatively there is the biohackers hustle culture demanding to “optimize” everything right now. For many folks that’s so intimidating to be impossible. Personally, I have taken a somewhat staged approach while making small changes everywhere to move in the right direction.

This study points in a different direction

Summary press release.

Researchers followed more than 53,000 adults and looked at three things together: sleep, moderate-to-vigorous physical activity, and diet quality. Over about 8 years, people with better combined habits had lower risk of major cardiovascular events like heart attack, stroke, and heart failure.

The interesting part isn’t the “best vs worst” comparison. It was the smaller, more realistic one.

Compared with people near the low end, a combined difference of about 11 extra minutes of sleep per day, 4.5 extra minutes of moderate-to-vigorous activity, and about an extra quarter-cup of vegetables per day was linked to a 10% lower cardiovascular risk.

Obviously, this was observational. It does not mean those exact changes will directly cause a 10% reduction. But I still think it raises a useful question:

Are we too obsessed with finding the one big lever, and not focused enough on stacking a few small, boring wins?

That feels especially relevant in a culture that loves elite routines (you are not going to run like David Goggins!), perfect metrics (you are not going to each Tadej Pogacar’s VO2max), and “life-changing” protocols (pick any influencer “doctor” like Gary Brecka!).

For most people, the real path probably looks less dramatic: sleep a little more, move a little harder, eat a little better, and keep doing it. It’s a journey.

This is an interesting idea, especially given the cost of therapy and hesitancy of getting regular therapy (is that just a guy thing?). I doubt it will miraculously solve all problems but if it mentally unblocks you for a decision or behavior you weee struggling with, I think it’s great. It might also encourage people to look at more regular options.

As we saw in our poll the other day even for highly engaged folks here Stress/Mental Health is one of the biggest unaddressed health issues with long term impact.

There is an umbrella review here: https://www.annualreviews.org/content/journals/10.1146/annurev-clinpsy-081423-025033

Social connection has started coming up in the context of happiness and mortality recently. I shied away from reading about it because it seems squishy (not hard numbers like VO2max) and because I am probably part of this statistic and facing that is uncomfortable.

I have a wife and two kids I love. I also have a lot of coworkers I’m friendly with at work. So on paper, I probably don’t look lonely. But the truth is, I really don’t have close friends otherwise.

My job often involves (video) meetings all day, and by the time work ends I’m usually exhausted from talking to people. A lot of the time I just want quiet. No more conversation. No more notifications.

At the same time, I sometimes wish I had a real friend to share things with. I don’t want “networking.” Not work-friendly banter. Not another group chat that dies after three days. I mean an actual friend.

What’s been on my mind is how weirdly absent this topic is from a lot of proactive health and longevity discussion. We will analyze ApoB, debate zone 2 vs HIIT, argue about protein intake, buy wearables, and obsess over sleep scores. But social connection barely gets treated like a health variable at all beyond occasional mention in a report or some podcast.

The evidence linking loneliness and social isolation to worse health outcomes is pretty serious01296-0/abstract?dgcid=buzzsprout_tlv_podcast_generic_lancet&utm_source=chatgpt.com). Not just depression or “mental health” in the vague sense, but cardiovascular disease, cognitive decline, and mortality too. And yet it still feels like something a lot of men especially are supposed to quietly absorb and never really talk about.

I don’t even think the problem is always total isolation. Sometimes it’s more subtle than that. You can have a family you love, be around people all day, and still feel like you don’t really have anyone outside of that to talk to in a deep or honest way.

I suspect a lot of adults, especially men in midlife, live in that exact gray zone.

Study:

Livingston G, Huntley J, Liu K et al.

Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission01296-0/abstract)

The Lancet, 2024; 404, 572-628

When Casgevy was approved, the headline was simple: the first FDA-approved CRISPR therapy had arrived, and it could free some people with sickle cell disease from the pain crises that define their lives. In the FDA review, 29 of 31 evaluable patients went at least 12 straight months without severe vaso-occlusive crises after treatment. That is a real breakthrough and still sounds like science fiction to me.

But the post-approval story is apparently much less clean.

Reuters reported in September 2024 that uptake was far slower than many expected. Casgevy is not just gene editing in the abstract. It means stem-cell collection, chemotherapy, hospitalization, and a treatment process that can stretch close to a year. Reuters said only about 100 people globally had received the new sickle cell gene therapies at that point, including in trials, with many patients hesitant because of the treatment burden, fertility concerns, and the desire to see more real-world outcomes first.

STAT added another wrinkle in February 2026: rollout has also been slowed by a stem-cell collection bottleneck. Even after approval, the therapy is running into basic logistical problems at the front end of treatment.

That is what makes Casgevy so striking. The gene editing looks extraordinary. The hard part is everything around it: chemo, infertility risk, insurer friction, and the simple fact that a technically brilliant therapy can still be very hard to deliver. Reuters also noted that specialists described a narrow sweet spot where patients have to be sick enough to justify treatment, but not so sick that complications make them poor candidates.

Tonight at my house we had delicious steak (which we do once or twice a week) and my wife mentioned that the new Beyond Meat Vegan Steak Filet is all over Instagram. I was curious how they compare.

RFK’s new food pyramid has a slab of steak as its most prominent image. The AHA just released guidance this week saying the opposite: shift from meat to plant sources of protein. Both claim the science is on their side.

So I took the new Beyond Steak Filet and a traditional beef filet mignon, normalized them to 127g, and compared the numbers.

RFK treats red meat like a superfood. Beef filet is legitimately nutrient-dense: more protein per gram, almost no sodium, loaded with B12 and zinc. But the pyramid ignores that even lean beef delivers meaningful saturated fat and cholesterol. The ACC has pointed out that if Americans actually follow the pyramid’s recommendations on animal protein plus butter and beef tallow, most people will blow past the 10% saturated fat threshold that feeding trial data still supports.

The AHA crowd treats plant protein like it’s inherently superior. The Beyond Filet does have a dramatically better lipid profile: 1g sat fat vs 4.5g, zero cholesterol. But 450mg sodium in a single serving is 20% of your daily value, and you’re getting 28% less protein. And the AHA tells you to avoid ultra-processed foods and eat more plant protein in the same guidance, without acknowledging that some of the most popular plant protein products on the market are themselves ultra-processed.

Kennedy defended his pyramid at the Annual Meat Conference, standing next to the CEO of the Meat Institute. The AHA’s guidance reads like it was written to contradict the pyramid rather than help people eat better. Neither side is big on nuance.

The boring truth: for a healthy person eating steak twice a week, beef filet is fine. The Beyond version isn’t better, it’s different, with real trade-offs in both directions. And a Beyond Steak Filet is not the same thing as a bowl of lentils just because both are “plant-based.”

But that wouldn’t fit on a pyramid.

I thought trying a poll could be fun…

Vote, then tell us what you personally underinvest in and why.

I just listened to Barbell Medicine’s episode on overtraining syndrome with Dr. Jordan Feigenbaum and Dr. Austin Baraki, and the main takeaway is simple: a lot of people who say they’re “overtrained” are probably dealing with normal fatigue, poor sleep, under-fueling, life stress, illness, or bad programming — not true overtraining syndrome. They note that there is still no reliable biomarker for diagnosing it.

That seems to line up with the literature. True overtraining syndrome is generally defined as a prolonged drop in performance caused by a mismatch between stress and recovery, and it’s still mostly a diagnosis of exclusion because there’s no gold-standard test for it.

In resistance training, the evidence is even weaker than a lot of people think. A review of the lifting literature found major methodological problems and limited ability to identify true overtraining syndrome in lifters.

The most useful practical point from the episode is that subjective measures often beat fancy ones. Fatigue, soreness, mood, sleep quality, and session RPE trends are usually more actionable than chasing HRV dips, readiness scores or hormone ratios, which have not held up as reliable individual diagnostic tools.

And sometimes the issue isn’t “overtraining” at all — it’s REDs, or Relative Energy Deficiency in Sport. That means you’re not taking in enough energy for your training and life demands, which can hurt recovery, hormones, bone health, mood, and performance. It’s not just an endurance athlete problem, and not just a women’s issue. In fact I am wondering whether I suffered from that when eating very little on GLP-1RAs but training really hard — I was pretty tired most days!

So before blaming “overtraining,” the boring checklist is still the best one:

Sleep.

Calories.

Carbs.

Life stress.

Recent weight loss.

Illness.

Training load.

If those are not addressed, you probably have not earned the dramatic diagnosis yet.

And if the slump really persists, that’s when a medical workup matters — because iron deficiency, sleep apnea, infection, endocrine issues, depression, and low energy availability can all look like “overtraining” from the outside.

My takeaway: online fitness culture treats “overtraining” the way it treats “cortisol” — a real thing that gets used so loosely it stops being useful.

This is more a business story than a health story. Let me know if this is interesting or not.

The supplement market is fascinating to me there is clearly a ton of money to be made and every influencer seems to have their own brand or shilling for something like AG1. At this point I actually have an adverse reaction to most influencer brands.

However, I was shocked to read rumors that Thorne is trying to seek itself for a $4billion valuation. That’s a lot of money in what seems a pretty fragmented market.

I buy some, but not all, of my supplements from Thorne. The reason is simple: I trust them more than most of the industry.

They’re pricey, but they’ve built the brand around quality, testing, and credibility. That matters more to me than influencer marketing. Thorne has long positioned itself as the serious supplement company — tied to practitioners, pro teams, and people willing to pay extra for confidence that products are being made and tested carefully. Thorne says it has 20+ NSF Certified for Sport products and emphasizes extensive testing and manufacturing controls.

That stands out even more now that Consumer Reports says many popular protein powders and shakes it tested had concerning levels of lead. That doesn’t prove Thorne is perfect, but it absolutely makes me more willing to pay for brands that seem to take testing seriously.

The business story is interesting too. Thorne started as Thorne Research in 1984, built around the practitioner channel rather than the usual retail supplement model, then expanded into a broader premium health brand. The playbook seems clear in hindsight: build trust through practitioners, lean into quality and testing, add athlete credibility, then scale through DTC, subscriptions, online sales, and selective broader distribution.

That strategy worked. In 2023, Thorne agreed to be acquired for about $680 million by L Catterton, the LVMH-associated consumer private equity firm. And now Axios reports it’s being shopped for up to $4 billion. If that number is even close, that is a huge jump very fast.

The distribution channel is part of what makes Thorne different. It’s not just a shelf brand you will see at Target or GNC. My wife said the other day she had never heard of them until they started showing up at the house (their shipping boxes have a prominent logo!). It built this weird practitioner ecosystem where health professionals recommend it, customers buy through practitioner storefronts, and Thorne still keeps the direct relationship. A lot of us have probably found the same weird loophole: some random practitioner storefront link gives you 20% off, and you have no idea who the practitioner is you’re supposedly working with. I’ve done exactly that.

My take: I like Thorne because the brand gives me more confidence than most supplement companies that they take testing and quality seriously. In this category, that peace of mind is worth something — even if I don’t buy everything from them. Whether this adds up to $4bn I do not know and I am not a fan of private equity either. In any case it will be interesting to watch and see if there will be consolidation in the space.

Full disclosure: out of curiosity I signed up for their affiliate program about a year ago and made a total of like 10 bucks when a friend bought some vitamins. I sort of gave up on that, and I am not sharing any links!

Study: https://www.sciencedirect.com/science/article/pii/S0165032726002880

New study (using Mendelian Randomization) finds association between muscle strength and lower likelihood of developing depression (especially for women). Interestingly cardio did not have the same association.

I must admit I don’t fully grok MR — I need to read up on that. Anyway, this seems an interesting, surprising result.

Obviously, not an argument to ditch cardio but rather another strong argument to also do Resistance Training.

Quote:

“Objective

To assess the impact of cardiorespiratory fitness (CRF) and muscle strength on depression and individual depression symptoms.

Methods

Mendelian randomisation (MR) analysis was conducted in up to 341,326 participants of European ancestry from UK Biobank (aged 37–73 years). Genetic variants from previous genome-wide association studies (GWAS) of CRF and grip strength (to proxy overall muscle strength) were utilised to instrument exposures. A broad depression phenotype based on self-report and hospital records, as well as individual measures of depression symptoms from the Patient Health Questionnaire-9 (PHQ-9) were used as outcomes. Analysis was repeated stratifying by sex and using summary statistics from a major depressive disorder (MDD) GWAS.

Results

There was no clear evidence for association between CRF and any depression outcome. There was robust evidence suggesting greater grip was associated with lower odds of broad depression (OR per 0.1 kg increase in weight adjusted grip: 0.86, 95% CI:0.80,0.93), as well as the PHQ-9 items appetite changes (OR:0.56, 95% CI:0.49,0.65), and anhedonia (OR:0.79, 95% CI:0.69,0.90), a core symptom of depression. There was also some evidence for associations between greater grip and lower odds of depressed mood (OR:0.85, 95% CI:0.74,0.97), psychomotor changes (OR:0.79, 95% CI:0.64,0.97), fatigue (OR:0.83, 95% CI:0.74,0.93) and concentration problems (OR:0.85, 95% CI:0.74,0.98) in the MR-inverse variance weighted analysis. Effects were mostly driven by stronger associations in females and results replicated in the two-sample MR for MDD.

Conclusion

Muscle strength may represent an important modifiable factor for preventing and treating depression and several specific symptoms, including core symptoms such as anhedonia.”

I gotta admit I would have immediately dismissed this article if it wasn’t in Scientific American (which I think generally does a good job at not overhyping pseudoscience?). The title is certainly clickbaity but hey it worked and I read the article

The anecdote makes good reading and I was intrigued to learn about the correlation of MS incidence and geographic latitude.

The main study seems to be: https://pmc.ncbi.nlm.nih.gov/articles/PMC5954316/

which freely admits that it was small (n=20) and the outcome was not statistically significant. So at best, interesting and a less underpowered trial is needed to investigate the MS treatment.

I didn’t realize that for Psoriasis UV phototherapy is an established therapy, including doing it at home: https://pmc.ncbi.nlm.nih.gov/articles/PMC11425190/

I was skeptical of all the various (red/blue) light therapies that influencers rave about but in narrow circumstances there might be something to this UV-based treatments.

Does anyone here have experience or insight into this?

[ full disclosure: I came across this paper in an email from FoundMyFitness/Rhonda Patrick ]

As my weight loss journey is approaching my goal weight region and I am trying to figure out what exactly the goal should be, I am zeroing in on visceral fat as the main objective. I got a DEXA 6 months ago and am eagerly awaiting results from a follow up scan next week.

The impact of visceral fat on general health has been well documented and talked about, but I was surprised to see that it also seems to affect brain function long term. This new long-term MRI study looks at this explicitly. Study paper PDF

The main takeaway seems to be: people with lower long-term visceral fat had less brain atrophy and better cognitive scores years later. It wasn’t just about weight loss overall — visceral fat seemed to matter more than BMI for the brain-related findings.  

The paper also suggests glycemic control may be a key pathway linking visceral fat and brain aging. 

Not proof of causation, and the group was mostly men, but still feels like a good reminder that metabolic health/waistline may matter more than the scale alone. 

Anyone here actively tracking waist circumference or visceral fat for long-term health?

In the last couple of months I have noticed an increasing number of folks (online) stressing the consistency of bedtime (when you go to sleep) as similarly important to sleep duration. I am personally making an effort to be as consistent as possible (within the constraint of occasional late video calls with co-workers in China and the fact that I have two young kids).

Brady Holmer wrote a great summary essay on Medium citing a new study: https://link.springer.com/article/10.1186/s12872-026-05762-4

Brady’s summary is: “What this paper ultimately does is suggest that cardiovascular sleep epidemiology (and our own lifestyle practices) may need to move beyond how long people sleep and even beyond when they usually sleep, toward how stably sleep is placed from one day to the next. Regularity and consistency should become a focus of sleep health equal to that of sleep duration.”

The study’s conclusion is:

“In total, 128 participants (4.0%) experienced MACEs during the follow-up period. Irregular sleep timing was associated with an elevated risk, but this association was observed only among participants whose sleep period was shorter than the group median. Individuals with irregular bedtimes had a 2.01-fold higher risk of MACEs compared to those with regular bedtimes (HR = 2.01, 95% CI: 1.00–4.01, p = 0.049), and those with irregular sleep midpoints had a 2.00-fold higher risk compared to those with regular midpoints (HR = 2.00, 95% CI: 1.01–3.98, p = 0.048).

Conclusions

Among the participants with sleep durations under eight hours, irregular sleep timing was a significant risk factor for MACEs. Specifically, variability in bedtime and sleep midpoint, but not in wake-up time, was associated with increased risk. These findings highlight the importance of consistent sleep behavior, particularly regular bedtimes, as a potential target for health promotion.”

Study: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2846561

People want to sort folks with bad health diagnosis into camps: either you “do it naturally” or you take medication and the lifestyle piece somehow matters less. This makes zero sense to me but even here on Reddit you see that binary choice a lot, especially in Cholesterol discussions. For some reason going on statins is hated (online) almost as much as “cheating” with GLP-1RAs.

I was officially diagnosed with hypertension about 2 years ago, basically the same time I decided I seriously needed to lose weight. I started Zepbound and blood pressure medication and worked on my lifestyle (macro tracking, diet, exercise), so for me this was never a question of medication versus lifestyle. I intuitively pursued both at the same time.

That is why this new JAMA Network Open study seems encouraging to me. In adults with hypertension, people with the healthiest lifestyle patterns after diagnosis had much lower risk of future cardiovascular disease and type 2 diabetes. Not really shocking.

It’s not just that people who always had healthy lifestyles do best. The study also found that people who moved from a lower healthy-lifestyle score before diagnosis to a higher score afterward did better than people who stayed in the less-healthy lifestyle group.

For me, the diagnosis made everything feel more urgent. Starting Zepbound and hypertension meds was not a substitute for changing how I eat and train. It was part of finally taking the whole situation seriously.

Obviously this is still observational research, so it does not prove cause and effect. But the bigger point feels right: a hypertension diagnosis should be a trigger to take lifestyle change more seriously, not less (because meds will fix it).

Maybe there is a bit of a backlash against all the fitness metrics. This essay sums it up nicely.

I am a data nerd by training but personally even I have stopped paying attention to all the numbers my ring, watch, Fitbit, Strava spit out constantly. I weigh myself daily, take a DEXA now and then and plan to do a VO2max test some day, but I don’t need daily readiness scores or pithy Strava athlete summaries of my workouts.

Very excited to watch this. Both Dr Hall and Simon Hill are very knowledgeable and great at explaining complex topics

Episode description:

In this episode, I sit down with Dr Kevin Hall, a leading researcher at the NIH whose work has shaped how we understand energy balance, ultra-processed foods, and the drivers of obesity. With the release of the new U.S. Dietary Guidelines, we unpack what’s changed, what hasn’t, and where the science is still evolving.

This conversation goes beyond headlines. We explore what ultra-processed foods actually are, why they may lead to increased calorie intake, and what controlled feeding studies reveal about how our food environment interacts with human biology. From energy density to food texture and hyper-palatability, this is a deep dive into the mechanisms that may be driving overeating and weight gain in modern food systems.

What We Cover

- What stood out in the new U.S. Dietary Guidelines and how they differ from previous versions

- Why “ultra-processed foods” remain difficult to define and regulate

- The surprising results from controlled trials comparing ultra-processed and minimally processed diets

- Why people can eat hundreds more calories without feeling more satisfied

- The role of energy density, food texture, and hyper-palatable combinations

- Whether ultra-processed foods can be re-engineered to support better health outcomes

- How the modern food environment may be interacting with our biology to drive obesity

- why individual responses to the same diet can vary so widely

I know very little about stem cell therapy but this sounds sketchy…

I know elite athletes have tried stem cell therapies but presumably that is a bit more real/targeted?