Simon Hill

Dr. Will Bulsiewicz, a board-certified gastroenterologist, explains that the gut microbiome is an important contributor to metabolic health. Low fiber intake is associated with reduced microbial diversity and may contribute to impaired gut barrier function, allowing greater translocation of bacterial products such as lipopolysaccharide (LPS) into the bloodstream. A healthy microbiome ferments fiber into short-chain fatty acids (SCFAs) — butyrate, acetate, propionate — that activate appetite-regulating hormones (GLP-1, PYY) and may also influence energy metabolism through multiple pathways currently under investigation. Most adults in the US fall well short of recommended fiber intake, and increasing fiber and plant diversity is one of the more practical levers available for improving metabolic health.

Pushing your body to grow faster, with growth-hormone drugs or high protein, may speed up aging rather than slow it. The same drugs that build muscle or drop weight quickly can carry a long-term cost. Cycling between normal eating and short, planned fasting periods may offer repair without that cost.

A CT scan plus computer analysis can now measure how much plaque is in your heart arteries, and what it is made of, rather than estimating your risk from blood markers. Many people who have a heart attack had no warning symptoms beforehand, and a calcium score of zero cannot see soft plaque at all. The headline claim of a 48% reduction over 16 months is less solid than it sounds: two other analysis tools read the same scans and disagreed, including on the direction.

Heart disease from narrowing arteries usually builds up gradually over decades, as cholesterol-carrying particles lodge in the artery wall and form fatty plaques. A blood marker called ApoB counts these particles directly, and it can flag risk a standard cholesterol test misses. Several proven medicines lower these particles in different ways. This discussion covers how they work, how well they prevent heart attacks and strokes, and why starting earlier may matter.