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Autoimmune

Hello Peter, Im 50 with RA, very muscular and very fit! I’ve always lived a healthy lifestyle, but now have RA! I’m obsessed with CVD because it will likely get me in the end. My family history of RA stated in 1950, since then 18 family members hit, plus pulmonary disease! If it ever happens maybe you could interview an everyday guy with an amazing understanding of metabolic disease and share how to be strong with RA. Mainly how I use Asian herbs to fight atherosclerosis and what they do to breakup protein aggregation! I’m in Naples Florida where I work with my clients becoming metabolically flexible! Thank you for your time and mostly your sharing of amazing knowledge

Sleep suggestions for those on frequent call

I'm a pediatric anesthesiologist (but cover all types of cases and OB) two years out of training and a member of an independent physician practice. I love this practice. We are fighting the good fight against the aspects of corporate medicine that threaten patient safety and physician autonomy. We all take some sort of in-house call every 1-2 weeks (usually 24h, sometimes 16h). Our recently-retired partners, despite outward seeming health, have had a multitude of health issues from cancer to MIs that underscore your emphasis on sleep as a top 3-5 pillar of longevity. With young kids and this schedule, I can already feel the impact it is taking on me even in my 30s. Any thoughts about how you would approach this situation? I'm taking care of what I think are the low-hanging fruit (regular exercise with lots of Zone 2 training, time-restricted feeding and a good diet, dabbling with meditation/self-compassion practices, basic sleep hygiene, and some magnesium threonate), but anything else you would layer on? Lastly, I had cancer as a kid and have a host of issues related to chemo/radiation including but not limited to non-cirrhotic portal HTN -> esophageal varices s/p spleno-caval shunt, and if you ever want to take on a new patient who would do whatever you told them or have suggestions about finding a PCP who practices with a mind for longevity and half of your team's attention to detail, please let me know.

Fasting and fatty liver

According to Gerald Shulman's discussion regarding starvation, it would seem that fasting, particularly fasting for a week, would cause fatty liver. That doesn't sound like a good thing to do. What am I missing?

Which SGLT2 inhibitor to choose for a healthy adult?

Could you please tell us which SGLT2 inhibitor you chose to use personally, and why? Which others would or wouldn’t you consider for you or your patients? Thanks!

NUTRIGENOMIX

Have you done any research on Nutrigenomix? They analyze your DNA for gene mutations giving specific recommendations related to weight management, body composition, cardiometabolic health, food intolerances, eating habits, various performance related elements and injury risk. What are your thoughts as to the usefulness and/or validity of this?