The cure for most cases of type 2 diabetes (T2DM) requires fat loss. This thread will discuss research showing restoration of carbohydrate tolerance in those with T2DM through addressing the underlying pathology (ectopic fat) rather than just focusing on symptom management.

@Alexleaf explains why he can't understand the "supplements are a scam" belief, and the marketing trick that lets brands make big claims without ever disclosing the actual dose. Hosted by @theNOBSdentist, @CalvinandNOBS, and @TJ_Bongiorno. Brought to you by: NOBS: nobsroutines.com/ The Outgoing Co.: theoutgoing.co/ Full episode here or YouTube: DTHshow

@Alexleaf ran a systematic review on keto and athletic performance. What he found once researchers actually tested elite athletes wasn't what keto's biggest defenders expected. Hosted by @theNOBSdentist, @CalvinandNOBS, and @TJ_Bongiorno. Brought to you by: NOBS: nobsroutines.com/ The Outgoing Co.: theoutgoing.co/ Full episode here or YouTube: DTHshow

Part of what makes GLPs so powerful is that they can alter behavior before a person ever reaches conscious contemplation. Many people never meaningfully consider a different way of eating or living because they have never experienced the physiological and psychological conditions that make that alternative feel preferable. GLPs can change the reward landscape first, and cognition often catches up afterward. For some people, cognition never catches up to the behavioral shift, which is why many revert after discontinuation. But that outcome is not inevitable. The period on a GLP can become evidence—>if someone consciously updates the perceived benefits of food, movement, satiety, and their old habits, the new behavior can become genuinely preferable rather than merely pharmacologically easier.

Obesity is driven by a number of interacting factors that all converge to affect its proximal cause: chronic energy surplus. Beliefs, priorities, and preferences are the biggest factors. Most people simply have no desire to be healthy or to put in the effort required to be healthy in the modern environment. And appreciating this truth and the agency that people possess is not mutually exclusive with everything else that follows. Hyperpalatable food supply is next, defined by food options rich in combinations of added sugars, refined grains, added fats, salt, and flavorings. None of these things is obesogenic on its own. Inactivity comes third. People don't want to be active, and the modern environment is great at allowing people to live their lives with very little physical activity being needed. Then you have things like genetics, sleep and circadian disruption, chronic stress, medications, socioeconomic factors, alcohol, toxicants, and the microbiome. Key thing is figuring out what the biggest levers are for a particular person. But energy balance remains king, and encouraging personal agency over behavior is essential (e.g., no food will ever compel you to eat it).

As someone who is a huge fan of supplements in general, it really irritates me to the core to see companies sell products with complete bullshit claims like this. You cannot tell me with a straight face that 100 mg of your collagen product is equivalent to 10 grams of another.

I think they are both underappreciated supplements that have large potential for benefit with little risk of harm, and they are cheap. Clinical trials on taurine suggest that 1-6 grams per day can improve some aspects of athletic performance (TTE and power output; PMID: 29546641) and reduce markers of oxidative stress and inflammation (T2D PMID: 32015761; obesity PMID: 24065043). Melatonin is one of the most potent antioxidants that we make with a cool evolutionary history (PMID: 26272235). Clinically, helps improve a number of metabolic biomarkers with 3-12 mg per night (PMIDs: 39428939; 29907916; 30647466). Has much more modest effects for sleep than many people think, but still a tendency for benefit depending on your starting point. Both are worthy of further investigation by anyone interested. The above is an incredibly abbreviated list of their effects, both mechanistic and clinical.

I love watching them together🥹💙

One of the only studies to ever investigate a reasonably high protein intake in people with overweight and obesity (PMID: 26817506).

Supplements are awesome. Many have a solid base of evidence supporting their use for specific health goals. Evaluate each one on its own merits and avoid making sweeping generalizations. Easy.

Skin, joint, bone, gut (maybe). Benefits of collagen peptides continue to accumulate. It's not a miracle supplement by any means, but it's simply illogical to think that collagen is a scam or provides no benefits.

This is actually easily explainable and it isn't the "dunk" or whatever some people think it is. At the most fundamental level, linoleic acid (LA) concentration and percentage are separate biological variables. You can see this with a simple hypothetical: the first person is metabolically healthy while the second person isn't. Healthy person: Total fatty acids = 4 mmol/L LA = 1.2 mmol/L LA = 30% of total Unhealthy person: Total fatty acids = 8 mmol/L LA = 1.6 mmol/L LA = 20% of total The LA concertation increased by 33% in the unhealthy person, but the percentage decreased from 30% to 20%. And this would result in the exact thing you see among these graphs, where higher metabolic risk correlates with both higher LA concentrations and lower LA percentage. This is almost certainly what was happing in the NHANES cohort from this study because total circulating fatty acid concentrations were positively correlated to triglyercides, LDL, cholesterol, insulin, glucose, blood pressure, BMI, and waist circumference. And LA increased as total fatty acids increased, but not nearly as quickly, meaning that percentage of LA fell while concentration of LA increased as someone became more metabolically unhealthy. Basically, LA concentration may simply be inheriting the association between total circulating fatty acids and metabolic dysfunction. Just take a step back here and imagine someone with insulin resistance. These people have a larger circulating pool of fatty acids overall, including LA. So of course LA concentration tracks with insulin, just like nearly every other fatty acid. So, if anything, these results aren't evidence that LA concentration is itself harmful.

Social media is flooded with extreme health advice that completely ignores actual science. Alex Leaf breaks down the most persistent nutrition myths online, debunking everything from plant toxicity and carbohydrate fear-mongering to extreme carnivore diet claims. Full episode here or on YouTube: DTHshow Guest: @Alexleaf

I absolutely love collagen. High reward, low cost supplement that does so many cool things in our bodies.

Look who I see 👀

Just got the images back from our anatomy scan. So impressed with how fast they grow. We are all so in love already🥹💙

We assume the loudest nutrition claims online are the ones worth listening to. @alexleaf says that's exactly backwards. Alex Leaf on why his own research found keto hurts elite athletic performance, and why saffron holds its own against antidepressants in nine separate studies. Full episode here or on YouTube: DTHshow

New podcast!

If someone tells you with a straight face that vegetables have toxins causing population-level diseases, you can just ignore them.