Bedankt!

#69 - Ronesh Sinha, M.D.: Insights into the manifestation of metabolic disease in a patient population predisposed to metabolic syndrome, and what it teaches us more broadly

In this episode, Dr. Ronesh Sinha, a physician, author, and educator based in Silicon Valley, shares his many insights into metabolic illness that he has gleaned from his South Asian patient population. In this conversation we focus on hyperinsulinemia, insulin resistance, metabolic dysregulation, inflammation, blood pressure, obesity, etc. and ways to address them with nutrition, sleep, exercise, stress management, and more. We also take a deep dive into insulin resistant phenotypes, evolutionary theory and geographic determinants of insulin resistance which provides insight into the genetic architecture and pathophysiology of metabolic syndrome. Additionally, we discuss the surprisingly interrelated topic of stress, and how we might be inadvertently passing this on to our children, leading to mental and physical sickness down the road.

We discuss:

  • How a stubborn case of insulin resistance connected Peter with Ronesh [7:15];
  • Ronesh’s clinical treatment focus of metabolic illnesses in South and East Asian patient populations [8:45];
  • The distinction between visceral fat and subcutaneous fat stores [15:00];
  • Shortcomings of a body mass index (BMI) calculator for evaluating metabolic disease risk [17:15];
  • Cortisol and blood glucose variability [28:30];
  • Insulin’s role in elevated blood glucose: A symptom of metabolic syndrome [33:25];
  • Mechanistic explanations of insulin resistance (there may be more than one) [35:15];
  • Theories on origins and evolutionary reasons for insulin resistance [40:00];
  • The inverse relationship between the amount of brown adipose tissue and rates of insulin resistance, and the role of climate in patterns and prevalence of insulin resistance [49:50];
  • Vitamin D levels, hyperinsulinemia, and other effects [53:45];
  • The evolutionary benefit of being able to turn fructose into fat (and the price we are now paying for it) [58:00];
  • The VO2 max relationship to insulin resistance and familial metabolic health [59:30];
  • Using zone 2 fitness test to evaluate mitochondrial performance [1:01:15];
  • Exercise for long-term functional health [1:06:00];
  • Lifestyle changes to improve insulin resistance and other metabolic phenotypes [1:14:00];
  • Is PCOS a manifestation of insulin resistance? [1:21:00];
  • The impact of stress on adiposity, and Peter’s treatment regimen for overweight females resistant to typical nutritional approaches [1:23:45];
  • How a culture of achievement and expectations can lead to undue stress, unhappiness, and health problems in our children (a Silicon Valley case study) [1:35:00];
  • The negative impact of devices and social media on children [1:48:45];
  • How you can help yourself, your family, and your community without being an MD or PhD [1:55:00]; and
  • More.

Learn more: https://peterattiamd.com/

Show notes page for this episode:https://peterattiamd.com/roneshsinha/

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2021-03-08 - 163 min

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2021-03-08 - 151 min

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2021-03-08 - 174 min

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#53 - AMA #6: Fasting framework, vitamin supplementation, antioxidants, time management, problem-solving, and more

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2021-03-08 - 6 min

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#81 - Debra Kimless, M.D. & Steve Goldner, J.D.: Cannabis – the latest science on CBD & THC

2021-03-08 - 6 min

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2021-03-08 - 130 min

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2021-03-08 - 9 min

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2021-03-08 - 122 min

#83 - Bill Harris, Ph.D.: Omega-3 fatty acids

2021-03-08 - 8 min

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2021-03-08 - 10 min

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2021-03-08 - 11 min

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2021-03-08 - 173 min

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2021-03-08 - 7 min

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2021-03-08 - 147 min

#86 - Damon Hill: Overcoming loss, achieving success, and finding one's identity

2021-03-08 - 13 min

Qualy #85 - The past, present, and future of medicine, hospitals, and healthcare

2021-03-08 - 110 min

#87 - Rick Johnson, M.D.: Fructose—The common link in high blood pressure, insulin resistance, T2D, & obesity?

2021-03-08 - 9 min

Qualy #89 - Cortisol and healthy aging

2021-03-08 - 139 min

#88 - Paul Grewal, M.D.: Treating metabolic disease and strategies for long-term health

2021-03-08 - 7 min

Qualy #94 - Comparing the two broad types of meditation, and Peter’s favorite meditation apps

2021-03-08 - 14 min

#89 - AMA #11: All things fasting

2021-03-08 - 11 min

Qualy #99 - The steroid controversy: Mark’s use of them and Peter’s perspective

2021-03-08 - 136 min

#90 - Ryan Holiday: Stillness, stoicism, and suffering less

2021-03-08 - 7 min

Qualy #102 - Is the food industry still saying that all calories contribute equally to adiposity and insulin resistance?

2021-03-08 - 121 min

#91 – Eric Topol, M.D.: Can AI empower physicians and revolutionize patient care?

2021-03-08 - 9 min

Qualy #106 - Does LDL cause heart disease?

2021-03-08 - 15 min

92 - AMA #12: Strategies for longevity (which don't require a doctor)

2021-03-08 - 9 min

Qualy #109 - How does one select the right physician as a patient?

2021-03-08 - 127 min

#93 - AMA with Jason Fried: Work-life balance, avoiding burnout, defining success, company culture, and more

2021-03-08 - 8 min

Qualy #116 - Dealing with anger in spots where you know it’s coming

2021-03-08 - 110 min

#94 - Mark Hyman, M.D.: The impact of the food system on our health and the environment

2021-03-08 - 6 min

Qualy #120 - What is the difference between ketone salts and esters?

2021-03-08 - 98 min

#95 - Luke Bennett, M.D.: The emotional, cognitive, and physical demands that make Formula 1 a unique and special sport

2021-03-08 - 10 min

Qualy #121 - The “art” of longevity: the challenge of preventative medicine and understanding risk

2021-03-08 - 157 min

#96 - David Epstein: How a range of experience leads to better performance in a highly specialized world

2021-03-08 - 13 min

Qualy #125 - Hierarchies in healthcare, physician burnout, and a broken system

2021-03-08 - 57 min

#97 - Peter Hotez, M.D., Ph.D.: COVID-19: transmissibility, vaccines, risk reduction, and treatment

2021-03-08 - 65 min

#98 - Peter Attia, M.D. and Paul Grewal, M.D.: Coronavirus (COVID-19) FAQ

2021-03-08 - 9 min

Qualy #129 - Evolutionary reasons to sleep

2021-03-08 - 66 min

#99 - Peter Hotez, M.D., Ph.D.: Continuing the conversation on COVID-19

2021-03-08 - 92 min

#100 - Sam Harris, Ph.D.: COVID-19—Comprehending the crisis and managing our emotions

2021-03-08 - 82 min

#101 - Ryan Holiday: Finding stillness amidst chaos

2021-03-08 - 82 min

#102 - Michael Osterholm, Ph.D.: COVID-19—Lessons learned, challenges ahead, and reasons for optimism and concern

2021-03-08 - 77 min

#103 - Looking back on the first 99 episodes: Strong Convictions, Loosely Held

2021-03-08 - 34 min

#104 - COVID-19 for kids with Olivia Attia

2021-03-08 - 86 min

#105 - Paul Conti, M.D.: The psychological toll of a pandemic, and the societal problems it has highlighted

2021-03-08 - 44 min

#106 - Amesh Adalja, M.D.: Comparing COVID-19 to past pandemics, preparing for the future, and reasons for optimism

2021-03-08 - 81 min

#107 - John Barry: 1918 Spanish flu pandemic—historical account, parallels to today, and lessons

2021-03-08 - 15 min

#108 - AMA #13: 3-day fasting, exogenous ketones, autophagy, and exercise for longevity

2021-03-08 - 136 min

#109 - John Dudley: The beauty in archery, the love of practice, and a model system for life

2021-03-08 - 131 min

#110 - Lew Cantley, Ph.D.: Cancer metabolism, cancer therapies, and the discovery of PI3K

2021-03-08 - 17 min

#111 - AMA #14: What lab tests can (and cannot) inform us about our overall objective of longevity

2021-03-08 - 135 min

#112 - Ned David, Ph.D.: How cellular senescence influences aging, and what we can do about it

2021-03-08 - 22 min

#113: Normative errors—a conversation with my daughter about current events

2021-03-08 - 118 min

#114 - Eileen White, Ph.D.: Autophagy, fasting, and promising new cancer therapies

2021-03-08 - 97 min

#115 - David Watkins, Ph.D.: A masterclass in immunology, monoclonal antibodies, and vaccine strategies for COVID-19

2021-03-08 - 28 min

#116 - AMA with Dom D’Agostino, Ph.D., Part I of II: Ketogenic diet, exogenous ketones, and exercise

2021-03-08 - 103 min

#117 - Stanley Perlman, M.D., Ph.D.: Insights from a coronavirus expert on COVID-19

2021-03-08 - 134 min

#118 - Lloyd Klickstein, M.D., Ph.D.: Rapamycin, mTOR inhibition, and the biology of aging

2021-03-08 - 99 min

#119 - Terry Real: Breaking the cycle of shame, anger, and depression

2021-03-08 - 28 min

#120 - AMA with Dom D’Agostino, Ph.D., Part II of II: Ketosis for cancer and chronic disease, hyperbaric oxygen therapy…

2021-03-08 - 114 min

#121 - Azra Raza, M.D.: Why we're losing the war on cancer

2021-03-08 - 90 min

#122 - Lori Gottlieb: Understanding pain, therapeutic breakthroughs, and keys to enduring emotional health

2021-03-08 - 137 min

#123 - Joan Mannick, M.D. & Nir Barzilai, M.D.: Rapamycin and metformin—longevity, immune enhancement, and COVID-19

2021-03-08 - 16 min

#124 - AMA #15: Real-world case studies—metabolic dysregulation, low testosterone, menopause, and more

2021-03-08 - 148 min

#125 - John Arnold: The most prolific philanthropist you may not have heard of

2021-03-08 - 101 min

#126 – Matthew Walker, Ph.D.: Sleep and immune function, chronotypes, hygiene tips, and addressing questions about his …

2021-03-08 - 15 min

#127 - AMA #3 with sleep expert, Matthew Walker, Ph.D.: Fasting, gut health, blue light, caffeine, REM sleep, and more

2021-03-08 - 113 min

#128 – Irene Davis, Ph.D.: The evolution of the foot, running injuries, and minimalist shoes

2021-03-08 - 120 min

#129 - Tom Dayspring, M.D.: The latest insights into cardiovascular disease and lipidology

2021-03-08 - 119 min

#130 - Carol Tavris, Ph.D. & Elliot Aronson, Ph.D.: Recognizing and overcoming cognitive dissonance

2021-03-08 - 111 min

#131 - Beth Lewis: The Art of Stability: Learning about pain, mitigating injury, and moving better through life

2021-03-08 - 19 min

#132 - AMA #16: Exploring hot and cold therapy

2021-03-08 - 132 min

#133 - Vinay Prasad, M.D., M.P.H: Hallmarks of successful cancer policy

2021-03-08 - 129 min

#134 - James O’Keefe, M.D.: Preventing cardiovascular disease and the risk of too much exercise.

2021-03-08 - 114 min

#135 - BJ Miller, M.D.: How understanding death leads to a better life

2021-03-08 - 18 min

#136 - AMA #17: Body composition methods tour de force, insulin resistance, and Topo Chico

2021-03-08 - 95 min

#137 - Paul Offit, M.D.: An expert perspective on COVID-19 vaccines

2021-03-08 - 131 min

#138 - Lauren Miller Rogen and Richard Isaacson, M.D.: Alzheimer’s disease prevention—patient and doctor perspectives

2021-03-08 - 76 min

#139 - Kristin Neff, Ph.D.: The power of self-compassion

2021-03-08 - 128 min

#140 - Gerald Shulman, M.D., Ph.D.: A masterclass on insulin resistance—molecular mechanisms and clinical implications

2021-03-08 - 16 min

#141 - AMA #18: Deep dive: sugar and sugar substitutes

2021-03-08 - 134 min

#142 - Robert Abbott: The Bobby Knight story—a cautionary tale of unchecked anger, ego, and winning at all costs

2021-03-08 - 112 min

#143 - John Ioannidis, M.D., D.Sc.: Why most biomedical research is flawed, and how to improve it

2021-03-08 - 82 min

#144 - Phil Maffetone: Optimizing health and performance through maximal aerobic function

2021-03-08 - 17 min

#145 - AMA #19: Deep dive on Zone 2 training, magnesium supplementation, and how to engage with your doctor

2021-03-08 - 117 min

#146 - Guy Winch, Ph.D.: Emotional first aid and how to treat psychological injuries

2021-03-08 - 126 min

#147 - Hussein Yassine, M.D.: Deep dive into the “Alzheimer’s gene” (APOE), brain health, and omega-3s

2021-03-08 - 134 min

#148 - Richard Miller, M.D., Ph.D.: The gold standard for testing longevity drugs: the Interventions Testing Program

2021-03-08 - 23 min

#149 - AMA #20: Simplifying the complexities of insulin resistance: how it's measured, how it manifests in the muscle a…

2021-03-08 - 143 min

#150 - Senator Bill Frist, M.D.: A modern Renaissance man's journey through science, politics, and business

2021-03-08 - 133 min

#151 - Alex Hutchinson, Ph.D.: Translating the science of endurance and extreme human performance

2021-03-08 - 95 min

#152 - Michael Rintala, D.C.: Principles of Dynamic Neuromuscular Stabilization (DNS)