2/ Also, it's all very mechanistic, with ANGPTL4 vs. 3/8 being oppositely regualted by feeding and fasting in a tissue specific manner such that fasting decreases fat storage in adopicytes and feeding promotes it.
And, perhaps, unsuprislingly, the lipid metabolism is...
3/ w.r.t ANGPTLs (and specifically 4, which controls local LPL activity) is linked with glucose homeostasis...
4/ Also, exercise locally induces ANGPTL4 in adipocytes so as to direct fat fuel to working muscles.
1/4) 🍩🦠 Today’s video covers breaking new research in Nature Metabolism about a Virus that Causes Food Addiction?!
But that’s not all! I’m proud to be collaborating with Metabolic Health Initiative—the ACCME-accredited medical education organization behind The Metabolic Health Summit @MetabolicSummit, and The Metabolic Link podcast. Together, we are working to get some of my content CME-accredited, including this video!
This creates an incentive for doctors to learn about metabolic health, as part of our broader efforts to Make Metabolic Health Mainstream! Read on, then Spread the Word!
2/4) Here's a review of findings in 4 Quick Points:
👉 A particular Microviridae virus can infect gut bacteria
👉 In so doing, the virus alters the metabolism of dopamine and serotonin precursors
👉 This is linked to changes in brain activity, on fMRI, and worse Food Addiction Scores
👉 "Fecal Viral Transplant" Experiments suggest a causal relationship between this virus and food addiction behavior
Thus, these data suggest an axis whereby a virus can contribute to the clinical signs of food addiction, a big step in demystifying the link between gut-brain and eating behavior
For details (and to hear from the senior author of this research), see link in 3/4
3/4) For more nuances, and to hear directly, from the senior author of this groundbreaking research, check out the full video, here:
🍩🧬Carbs and Codons: Understand Your Genes to Defeat Obesity 🧬🍩
1/6) This thread 🧵 review Mendelian Randomization that supports the Carbohydrate Insulin Model (#CIM) of Obesity. Let's dive in!
Background on Terms: CIM and Mendelian Randomization👇
🍩 The CIM is a mechanistic model of obesity that works as follows: a high glycemic load diet (meaning one that tends to spike blood sugar and blood insulin levels more) gives a hormonal signal to the body (high insulin) to store energy as fat tissue.
In other words, energy (calories) come in, and they’re “triaged:” preferentially towards fat, rather than energy expenditure or lean tissue.
As a downstream consequence, energy expenditure goes down and hunger increases. Thus, while “calories in – calories out = weight change” and thermodynamics is maintained, the calorie imbalance is the result of a primary hormonal disturbance.
🧬 Mendelian Randomization
A method scientists use to study whether a certain factor (like insulin secretion) causes a particular outcome (in this case, obesity).
It relies on genetic variations (remember those 4 million variable genetics sites?) that are assigned randomly by nature’s genetic coin toss to uncover cause-and-effect relationships.
🚨Study Question
So, in this study, the researchers asked the question, “does carbohydrate-stimulated insulin secretion (the amount of insulin released in response to a carbohydrate load) predict obesity?”
2/6) In this study, they used MAGIC! No, actually, they relied on data from the Meta-Analysis of Glucose- and Insulin-related traits Consortium (MAGIC), a previously published meta-analyses on insulin secretion including 26,037 people.
They also used data from the United Kingdom Biobank (n =138,541), and a validation cohort, the Cardiology and Metabolic Patient Cohort study at Massachusetts General Hospital (n =1,675).
Using prior knowledge about variations in the human genome, they created genetic risk scores for the traits: (i) carbohydrate-stimulated insulin secretion (how much insulin a person secretes in response to carbs), and (ii) body mass index (BMI).
3/6) The researchers found a higher insulin release genetic risk scores did predict higher BMI.
In fact, they even tested slightly different insulin release genetic risk scores in different populations and consistently found - “Yes!” - more insulin release in response to carbs, as influenced by genetics, did predict a higher BMI.
This is consistent with the #CIM: where higher insulin release tells fat cells to store fat, leading to obesity. This puts calories in the passenger seat where a calorie imbalance results, not from “just eating too many calories,” but from the hormonally stimulated growth of fat cells.
1/4) There are many strong, often dogmatic, opinions on GLP-1 receptor agonists. One interesting, and under-appreciated, fact is that GLP-1 aren’t "just" weight loss drugs.
They have complex metabolic effects, including reducing whole body inflammation by acting on the brain, partly in a weight-loss independent manner.
GLP-1 receptor agonists, and related medications, can help people but can also be misused at a societal level.
Let me elaborate (link 🔗 at the end)...
#GLP1 #inflammation
2/4) In their best use case, the metabolic actions of GLP-1 can catalyze lifestyle change. For example, reducing “food noise” permits patients to make healthier choices when set in a modern food environment that is itself obese with UPFs, sugar and temptation.
3/4) However, at a societal level, we should be cautious not to forget that the root cause obesity is metabolic dysfunction caused by an unhealthy lifestyle.
Thus, the core solution is lifestyle, and it’s unlikely we will “pharma” our way out of the obesity epidemic. However…
I am NOT saying “people should just live healthier.” Rather, I am saying that – as a society – we should push for a reevaluation of social norms around food and reconstruction of the food environment.
This can be in parallel to innovations in pharmacotherapy, deployed in the “right” patients. The determination of who those people are is not a matter for public discourse, it’s a private matter between physician and patient.
So, for our part, we should keep pushing for a change in the food environment, dysfunctional norms, and help people live a metabolically healthy lifestyle.
🧬💥What if I told you that social stress doesn’t just mess with your head—it damages your DNA and biologically ages you? (link at the end)
🧵1/9) That’s not hyperbole; it’s hard science from new data published in @NatureAging
If you’re like me—juggling a life full of psychological stress—you might be wondering: How can I fight back?
Let’s break down the data...
(I'll tease: this thread also includes a little honest opinionated "revealer" about @hubermanlab)
2/9) Background on Aging (Senescence and p16)
Aging is complex, and there’s no one easy way to measure biological age.
However, certain hallmarks of aging—like DNA damage, telomere shortening, and cellular senescence—are widely recognized.
“Senescence,” the process by which cells age and stop dividing, accumulates as we age and plays a role in chronic diseases like heart disease and Alzheimer’s.
While senescence has some adaptive functions, for our purposes, it’s fair to call it a hallmark of aging.
Senescence can be triggered by inflammation and DNA damage.
👉And senescence can be measured by markers, like “p16”. (If you want to remember this, just imagine the stress of having a pissed off 16 year old kid.)
3/9) Social Stress Increases Marker of Senescence
In this study the researchers subjected mice to chronic social stress or, more specifically, “chronic subordination stress”: The experimental mouse is exposed to an aggressive dominant mouse daily.
The human equivalent would be like a bully at school, an abusive parent, or a hyper-aggressive boss.
In just 4 weeks, the experimental mouse (the one that got bullied) exhibited increases in markers of senescence, predominantly p16.
And this marker of senescence and aging accumulated over time, with levels as high as 12X that of control mice by 26 months of age in circulating blood cells.
Unexpected Benefits of Compound Found in Olives on Muscles 🫒💪(link at the end)
1/9) High Level: These new data show how a specific compound found in part of the olive plant can improve muscle performance in the short term, and potentially fight off age-related muscle loss.
I’m going to first break down the data, and then tell you how to use it for maximal muscle benefit
#Exercise #Muscle #healthyaging
2/9 But first, I’m going to need to review with you a bit about how muscles work at the molecular level.
PLEASE bear with me here, because it will be fundamental to our discussion of the data – as well as your general understanding of how muscles work.
Inside muscles, there are long filamentous overlapping proteins called "actin" and "myosin." The myosin has these little heads that branch off and grab on to actin.
When a nerve impulse hits a muscle, it causes a release of calcium inside the cell, and this allows myosin to walk along actin, pulling them together and increasing the overlap between actin and myosin, which translates to shortening of the muscle – a muscle flex.
That, in effect, is a muscle contraction.
💪🧀Now, here’s something important: this process is highly dependent on calcium.
It’s calcium that allows the actin and myosin to interact. And its calcium that also signals to the mitochondria to meet the energy demands of a muscular contraction.
🏎️Analogy: Calcium is to muscle as a responsible driver of is to a car. Calcium presses the gas pedal (signals muscle contraction) and fuels the tank to keep the engines (mitochondria) running.
3/9 Okay, now let’s introduce 1 of 3 key players: the mitochondrial calcium uniporter (MCU).
MCU is what transports calcium into mitochondria, and thus enables signaling to mitochondria to boost energy production.
(We will explain how it does so momentarily.)
And the MCU is partnered with another protein, our 2nd player, MCU regulator 1 (or MCUR1), which is MCU’s essential sidekick: Like Batman and Robin.
MCU and MCUR1 work together to let calcium into mitochondria, and this is essential for energy production.
1/5) Unfortunately, some of my "anti-processed food" & "anti-sugar" content is being shadow banned on other platforms.
In this 9 min video, I discuss data around Food Dyes; Comment on the state of Safety Testing; And Ultimately point the Finger at the Elephant in the Room: Sugar 🍩
Have a listen and tell me if I'm being reasonable. Then read on...
cc @QuitSugarSummit (see 4/5) @KenDBerryMD @RobertLustigMD @DominicDAgosti2
2/5) We're living in an interesting time where there are dual revolutions happening
On the one hand, a pocket of the population is waking up to the fact that our food system and social norms are both dysfunctional and harmful. “Toxic” is a strong, but accurate descriptor.
People are making individual changes to optimize their metabolic health in the context of a broken food environment, and this will is spreading like a mind virus… a good one.
And, on the other hand, GLP-1s are changing the obesity medicine/pharma game. This isn't just a "eat less" phenomenon, but also an "eat different" phenomenon whereby these medications may be used to selectively decrease desire for Ultra Processed Foods.
I know this is controversial, but credit where it’s due. There are optimistic and pessimistic ways to paint this picture. But if we infuse medical innovations with this rising will to optimize true metabolic health, there may be more synergy here than we realize. (More on this soon, and for more on recent news on GLP-1s, see):
3/5) For my part, I’m all in about Making Metabolic Health Mainstream.
In 2025, we will be working on several “campaign,” including bringing metabolic health education to pre-medical student, providing doctors with CME-accredited content covering the latest metabolic health data, and scaling up my personal education and advocacy efforts as I emerge from an 11-year marathon through undergrad + an MD PhD (Yikes! Lots of school) with the autonomy and intellectual freedom to fight for the world’s metabolic health with a whole new level of vigor and ferocity.